Interleukin-6 is the strongest predictor of 30-day mortality in patients with cardiogenic shock due to myocardial infarction.
Crit Care. 2012 Aug 13;16(4):R152
Authors: Andrie RP, Becher UM, Frommold R, Tiyerili V, Schrickel JW, Nickenig G, Schwab JO
ABSTRACT: INTRODUCTION: Cardiogenic shock (CS) remains the leading cause of death in patients hospitalized for myocardial infarction (MI). Systemic inflammation with inappropriate vasodilatation is observed in many patients with CS and may contribute to an excess mortality rate. The purpose of this study was to determine the predictive role of serial measurements of Nt-proBNP, interleukin-6 (IL-6) and procalcitonin (PCT) for 30-day mortality in patients with CS due to MI. METHODS: The present study is a prospective single-center-study including 87 patients with MI complicated by CS treated with acute revascularization and intra-aortic-balloon-counterpulsation (IABP) support. Predictive values of plasma levels at admission (T0), after 24 hours (T1), and after 72 hours (T2) were examined according to 30-day mortality. RESULTS: Significant differences between survivors (n=59) and non-survivors (n=28) were seen for Nt-proBNP at T0, for IL-6 at T0 and T1, and for PCT at T1 and T2. According to ROC analyses, highest accuracy predicting 30-day mortality was seen at T0 for IL-6, at T1 for PCT, and at T2 for PCT. In univariate analysis significant values were found for Nt-proBNP at T1, for IL-6 and PCT at all points of time. Within the multivariate analysis, age, creatinine and IL-6 were significant determinants of 30-day mortality in which IL-6 showed the highest level of significance. CONCLUSIONS: In patients with MI complicated by CS, IL-6 represented a reliable independent early prognostic marker of 30-day mortality. PCT revealed a significant value at later points of time whereas Nt-proBNP seemed to be of lower relevance.
PMID: 22889197 [PubMed - as supplied by publisher]