BACKGROUND: The IABP-SHOCK-trial was a morbidity-based randomized controlled trial in patients with infarction-related cardiogenic shock (CS), which used the change of the quantified degree of multiorgan failure as determined by APACHE II score over a 4-day period as primary outcome measure. The prospective hypothesis was that adding IABP therapy to "standard care" would improve CS-triggered multi organ dysfunction syndrome (MODS). The primary endpoint showed no difference between conventionally managed cardiogenic shock patients and those with IABP support. In an inflammatory marker substudy, we analysed the prognostic value of interleukin (IL)-1β, -6, -7, -8, and -10 in patients with acute myocardial infarction complicated by cardiogenic shock. DESIGN: Inflammatory marker substudy of the prospective, randomized, controlled, open label IABP-SHOCK-trial (ClinicalTrials.gov ID-NCT00469248). SETTING AND METHODS: A single-center study was performed in a 12-bed Intensive-Care-Unit in an university hospital in which 40 consecutive patients were enrolled with an observational period of 96 h. RESULTS: The pro- and anti-inflammatory markers IL-6, -7, -8 and -10 showed a predictive power for mortality of infarct-related CS patients, while IL-1β did not discriminate. The maximal values during the observational period, in case of IL-7 the minimal value, showed the best power to predict mortality. Both, ROC and multivariate analyses confirmed these suggestions (area under the curve: IL-8, 0.80 ± 0.08; IL-6, 0.79 ± 0.08; IL-10, 0.76 ± 0.08; IL-7, 0.69 ± 0.08). Inflammatory markers were not affected by the presence of IABP support. CONCLUSION: The inflammatory response in patients with myocardial infarction complicated by cardiogenic shock, as reflected by the inflammatory markers IL-6, IL-7, IL-8 and IL-10, demonstrates a clinically relevant prognostic contribution to clinical outcome.
RCT Entities:
BACKGROUND: The IABP-SHOCK-trial was a morbidity-based randomized controlled trial in patients with infarction-related cardiogenic shock (CS), which used the change of the quantified degree of multiorgan failure as determined by APACHE II score over a 4-day period as primary outcome measure. The prospective hypothesis was that adding IABP therapy to "standard care" would improve CS-triggered multi organ dysfunction syndrome (MODS). The primary endpoint showed no difference between conventionally managed cardiogenic shockpatients and those with IABP support. In an inflammatory marker substudy, we analysed the prognostic value of interleukin (IL)-1β, -6, -7, -8, and -10 in patients with acute myocardial infarction complicated by cardiogenic shock. DESIGN: Inflammatory marker substudy of the prospective, randomized, controlled, open label IABP-SHOCK-trial (ClinicalTrials.gov ID-NCT00469248). SETTING AND METHODS: A single-center study was performed in a 12-bed Intensive-Care-Unit in an university hospital in which 40 consecutive patients were enrolled with an observational period of 96 h. RESULTS: The pro- and anti-inflammatory markers IL-6, -7, -8 and -10 showed a predictive power for mortality of infarct-related CS patients, while IL-1β did not discriminate. The maximal values during the observational period, in case of IL-7 the minimal value, showed the best power to predict mortality. Both, ROC and multivariate analyses confirmed these suggestions (area under the curve: IL-8, 0.80 ± 0.08; IL-6, 0.79 ± 0.08; IL-10, 0.76 ± 0.08; IL-7, 0.69 ± 0.08). Inflammatory markers were not affected by the presence of IABP support. CONCLUSION: The inflammatory response in patients with myocardial infarction complicated by cardiogenic shock, as reflected by the inflammatory markers IL-6, IL-7, IL-8 and IL-10, demonstrates a clinically relevant prognostic contribution to clinical outcome.
Authors: Christoph Liebetrau; Sebastian Szardien; Johannes Rixe; Mariella Woelken; Andreas Rolf; Timm Bauer; Holger Nef; Helge Möllmann; Christian Hamm; Michael Weber Journal: Clin Res Cardiol Date: 2010-09-21 Impact factor: 5.460
Authors: J S Hochman; L A Sleeper; J G Webb; T A Sanborn; H D White; J D Talley; C E Buller; A K Jacobs; J N Slater; J Col; S M McKinlay; T H LeJemtel Journal: N Engl J Med Date: 1999-08-26 Impact factor: 91.245
Authors: Roland Prondzinsky; Henning Lemm; Michael Swyter; Nikolas Wegener; Susanne Unverzagt; Justin M Carter; Martin Russ; Axel Schlitt; Ute Buerke; Arnd Christoph; Hendrik Schmidt; Matthias Winkler; Joachim Thiery; Karl Werdan; Michael Buerke Journal: Crit Care Med Date: 2010-01 Impact factor: 7.598
Authors: Rochus Witthaut; Christian Busch; Peter Fraunberger; Autar Walli; Dietrich Seidel; Günter Pilz; Ralph Stuttmann; Norbert Speichermann; Ljifane Verner; Karl Werdan Journal: Intensive Care Med Date: 2003-08-12 Impact factor: 17.440
Authors: Christian Jung; Christoph Rödiger; Michael Fritzenwanger; Julia Schumm; Alexander Lauten; Hans R Figulla; Markus Ferrari Journal: Clin Res Cardiol Date: 2009-04-15 Impact factor: 5.460
Authors: Ovidiu Chioncel; Sean P Collins; Andrew P Ambrosy; Peter S Pang; Razvan I Radu; Elena-Laura Antohi; Josep Masip; Javed Butler; Vlad Anton Iliescu Journal: Am J Ther Date: 2019 Mar/Apr Impact factor: 2.688