interleukin-6 is the strongest predictor of 30-day mortality in patients with cardiogenic shock due to myocardial infarction白细胞介素- 6的最强预测30天死亡率心原性休克患者由于心肌梗塞.pdfVIP

Andrié et al. Critical Care 2012, 16:R152 /content/16/4/R152 RESEARCH Open Access Interleukin-6 is the strongest predictor of 30-day mortality in patients with cardiogenic shock due to myocardial infarction *† † René P Andrié , Ulrich M Becher , Ricarda Frommold, Vedat Tiyerili, Jan W Schrickel, Georg Nickenig and Jörg O Schwab 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 intraaortic balloon counterpulsation (IABP) support. Predictive values of plasma levels at admission (T ), after 24 hours (T ), and after 72 hours (T ) were examined according to 30-day 0 1 2 mortality. Results: Significant differences between survivors (n = 59) and nonsurvivors (n = 28) were seen for Nt-proBNP at T , for IL-6 at T and T , and for PCT at T and T . According to ROC analyses, the highest accuracy predicting 0 0 1 1 2 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, and for IL-6 and PCT at all points in time. Within the multivariate analysis, age, creatinine, a