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Soluble triggering receptor expressed on myeloid cells-1 is a marker of organ injuries in cardiogenic shock: results from the CardShock Study

Abstract

Aims

Optimal outcome after cardiogenic shock (CS) depends on a coordinated healing response in which both debris removal and extracellular matrix tissue repair play a crucial role. Excessive inflammation can perpetuate a vicious circle, positioning leucocytes as central protagonists and potential therapeutic targets. High levels of circulating Triggering Receptor Expressed on Myeloid cells-1 (TREM-1), were associated with death in acute myocardial infarction confirming excessive inflammation as determinant of bad outcome. The present study aims to describe the association of soluble TREM-1 with 90-day mortality and with various organ injuries in patients with CS.

Methods and results

This is a post-hoc study of CardShock, a prospective, multicenter study assessing the clinical presentation and management in patients with CS. At the time of this study, 87 patients had available plasma samples at either baseline, and/or 48 h and/or 96–120 h for soluble TREM-1 (sTREM-1) measurements. Plasma concentration of sTREM-1 was higher in 90-day non-survivors than survivors at baseline [median: 1392 IQR: (724–2128) vs. 621 (525–1233) pg/mL, p = 0.008), 48 h (p = 0.019) and 96–120 h (p = 0.029). The highest tertile of sTREM-1 at baseline (threshold: 1347 pg/mL) was associated with 90-day mortality with an unadjusted HR 3.08 CI 95% (1.48–6.42). sTREM-1 at baseline was not associated to hemodynamic parameters (heart rate, blood pressure, use of vasopressors or inotropes) but rather with organ injury markers: renal (estimated glomerular filtration rate, p = 0.0002), endothelial (bio-adrenomedullin, p = 0.018), myocardial (Suppression of Tumourigenicity 2, p = 0.002) or hepatic (bilirubin, p = 0.008).

Conclusion

In CS patients TREM-1 pathway is highly activated and gives an early prediction of vital organ injuries and outcome.

Graphic abstract

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Data availability

Data are available from the corresponding author on reasonable request.

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Acknowledgements

To the CardShock Investigators: Greece: Katerina Koniari, Astrinos Voumvourakis, Apostolos Karavidas, John Parissis; Spain: Jordi Sans-Rosello, Montserrat Vila, Albert Duran-Cambra, Alessandro Sionis. Czechia: Jiri Parenica, Roman Stipal, Ondrej Ludka, Marie Palsuva, Eva Ganovska, Petr Kubena, Jindrich Spinar; Denmark: Matias G. Lindholm, Christian Hassager, Lars Køber; Finland: Tom Bäcklund, Johan Lassus, Raija Jurkko, Heli Tolppanen, Markku S Nieminen, Kristiina Järvinen, Tuomo Nieminen, Kari Pulkki, Leena Soininen, Reijo Sund, Ilkka Tierala, Jukka Tolonen, Marjut Varpula, Tuomas Korva, Mervi Pietilä, Anne Pitkälä; Italy: Rossella Marino, Salvatore Di Somma, Marco Metra, Michela Bulgari, Valentina Lazzarini, Valentina Carubelli; Portugal: Alexandra Sousa, Jose Silva-Cardoso, Carla Sousa, Mariana Paiva, Inês Rangel, Rui Almeida, Teresa Pinho, Maria Júlia Maciel; Poland: Marek Banaszewski, Janina Stepinska, Anna Skrobisz, Piotr Góral; Germany: Uwe Zeymer, Holger Thiele; The study was conducted in collaboration with the Global REsearch on Acute Conditions Team (GREAT) network (www.greatnetwork.com).

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The CardShock study was supported by grants from Aarne Koskelo Foundation, the Finnish Cardiac Foundation, and the Finnish State funding for university-level health research.

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Correspondence to Sebastien Gibot.

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Conflict of interests

Antoine Kimmoun. A K received speaker’s honoraria for lectures from Baxter, Aguettant and Aspen. Alexandre Mebazaa. AM reports personal fees from Orion, grants and personal fees from Roche, personal fees from Servier, personal fees from Otsuka, personal fees from Philips, grants and personal fees from Adrenomed, personal fees from NeuroTronik, grants and personal fees from 4TEEN4, personal fees from Sanofi. Sébastien Gibot. S G is a cofounder of INOTREM, a company developing an inhibitor of TREM-1. The remaining author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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Kimmoun, A., Duarte, K., Harjola, VP. et al. Soluble triggering receptor expressed on myeloid cells-1 is a marker of organ injuries in cardiogenic shock: results from the CardShock Study. Clin Res Cardiol 111, 604–613 (2022). https://doi.org/10.1007/s00392-021-01823-0

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Keywords

  • Biomarkers
  • STREM
  • Cardiogenic Shock
  • Outcome