Table 1 Studies investigating the role of inflammatory mediators in CS
Author | Cohort | Inflammatory biomarkers | n | Main findings |
|---|---|---|---|---|
Geppert [34] | Mixed CS vs SS vs non-critically ill patients Single centre | IL-6 | 88 | Higher IL-6 in CS patients with MOF vs CS without IL-6 > 200 pg/ml 93% specificity & 100% sensitivity for prediction of MOF |
Geppert [37] | Mixed CS vs SS vs non-critically ill patients Single centre | CRP and PCT | 66 | Median PCT elevated in CS patients vs non-critically ill controls, but not as high as those with SS PCT > 2 g/ml in CS correlated with organ failures |
Debrunner [38] | AMI vs AMI-CS Single entre | TNF-alpha; IL-6; IL1Ra | 41 | AMI-CS had significantly higher cytokine levels. IL-1Ra elevated early in course of AMI-CS |
Picariello [39] | CS following STEMI vs STEMI vs NSTEMI Single centre | PCT, CRP | 52 | CRP reflects degree of myocardial ischaemia. PCT reflective of higher degree of inflammatory activation, being positive in all CS patients |
Prondzinsky [40] | AMI-CS Single centre | IL-6, -7,-8, -10; IL-1β | 40 | IL-6, -7, -8 and -10 predicted mortality |
Prondzinsky [41] | AMI-CS Single centre | INF-gamma, TNF-alpha, MIP-1beta, G-CSF, MCP-1beta | 40 | Patients with elevated pro and anti-inflammatory cytokine levels had a higher risk of dying. Maximal levels are also suited to identifying survivors |
Andrié [36] | AMI-CS Single centre | IL-6, PCT, NT-pro-BNP | 87 | Multivariate analysis demonstrated that admission IL-6 had the highest level of significance in predicting 30-day mortality |
Fuernau [42] | AMI-CS Multi centre | GDF-16; Osteoprotegerin | 190 | Levels of GDF-15 on admission is an independent predictor of 30-day mortality |
Lipkova [43] | AMI-CS vs AMI Single centre | RANTES | 173 | Lower serum RANTES in AMI-CS vs AMI |
Liu [44] | MIxed-CS requiring ECMO Single centre | IL-6, -8, -10, MCP-1, TNF alpha, IL-1beta, Prdx1 | 46 | Prdx1 peaked earlier than other cytokines and a higher initial plasma level predicted a worse outcome |
Parenica [45] | AMI-CS Single centre | CRP, PCT, Presepsin, PTX3 | 80 | CRP and PCT both elevated but did not discriminate the presence of concomitant infection 12-h PTX3 highest AUC for 3-month mortality prediction |
Takagi [46] | Mixed CS Multi centre | cDPP3 | 57 | Association between levels of cDPP3 > 51.9 ng/ml & 90-day mortality. Delta cDPP3 within first 24 h correlated with mortality |
Cuinet [47] | Mixed CS Single centre | Differential WBC counts; IL-1β, IL-5, IL-6, IL-10, TNF-α, IFN-γ, MCP-1 and eotaxin (CCL11) | 24 | Elevated levels of IL-6, IL-10 and MCP-1 correlate with shock severity Patients with most severe shock have reduced lymphocyte and monocyte counts at 48 h and 6–8 days post-admission |
Kataja [35] | Mixed CS Multi centre | IL-6; PCT; CRP; GDF-15 | 183 | Elevated serum PCT & IL-6 associated with clinical & biochemical signs of hypoperfusion, organ dysfunction & mortality |
Büttner [48] | AMI-CS Multi centre | SelP | 147 | Levels > 75th percentile at day 3 significantly correlated with 30-day mortality |
Jentzer [49] | CICU population Multi-centre registry | NLR | 8280 | Elevated NLR associated with worse outcomes across shock severities |
Roth [50] | Mixed CS supported with VA-ECMO Single centre | NLR; PLR and PCT | 92 | NLR independently associated with mortality |
Dudda [51] | Mixed CS Single centre | CRP, WBCs | 240 | WBC of > 10 × 106/ml on admission and a > 200% increase in CRP between days 1 and 3 associated with increased 30-day mortality |
Wenzl [52] | AMI + AMI CS Multi-centre | cDPP3 | 4787 213 (AMI-CS) | High levels of cDPP3 independently associated with increased risk of development of in-hospital CS, with a dose–response relationship |