Background: There is evidence that monocyte chemoattractant protein-1 (MCP-1) levels
reflect the intensity of the inflammatory response in patients with cardiogenic shock (CS) complicating
acute myocardial infarction (AMI) and have a predictive value for clinical outcomes. However, little
is known about the effect of mild therapeutic hypothermia (MTH) on the inflammatory response in
patients with CS complicating AMI. Therefore, we conducted a biomarker study to investigate the
effect of MTH on MCP-1 levels in patients with CS complicating AMI. Methods: In the randomized
mild hypothermia in cardiogenic shock (SHOCK-COOL) trial, 40 patients with CS complicating
AMI were enrolled and assigned to MTH (33 ◦C) for 24 h or normothermia at a 1:1 ratio. Blood
samples were collected at predefined time points at the day of admission/day 1, day 2 and day 3.
Differences in MCP-1 levels between and within the MTH and normothermia groups were assessed.
Additionally, the association of MCP-1 levels with the risk of all-cause mortality at 30 days was
analyzed. Missing data were accounted for by multiple imputation as sensitivity analyses. Results:
There were differences in MCP-1 levels over time between patients in MTH and normothermia groups
(P for interaction = 0.013). MCP-1 levels on day 3 were higher than on day 1 in the MTH group
(day 1 vs day 3: 21.2 [interquartile range, 0.25–79.9] vs. 125.7 [interquartile range, 87.3–165.4] pg/mL;
p = 0.006) and higher than in the normothermia group at day 3 (MTH 125.7 [interquartile range,
87.3–165.4] vs. normothermia 12.3 [interquartile range, 0–63.9] pg/mL; p = 0.011). Irrespective of
therapy, patients with higher levels of MCP-1 at hospitalization tended to have a decreased risk of
all-cause mortality at 30 days (HR, 2.61; 95% CI 0.997–6.83; p = 0.051). Conclusions: The cooling
phase of MTH had no significant effect on MCP-1 levels in patients with CS complicating AMI
compared to normothermic control, whereas MCP-1 levels significantly increased after rewarming.
Trial registration: NCT01890317.
| Identifer | oai:union.ndltd.org:DRESDEN/oai:qucosa:de:qucosa:88462 |
| Date | 05 December 2023 |
| Creators | Cheng, Wenke, Fuernau, Georg, Desch, Steffen, Freund, Anne, Feistritzer, Hans-Josef, Pöss, Janine, Buettner, Petra, Thiele, Holger |
| Publisher | MDPI |
| Source Sets | Hochschulschriftenserver (HSSS) der SLUB Dresden |
| Language | English |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, doc-type:article, info:eu-repo/semantics/article, doc-type:Text |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 2308-3425, 10.3390/jcdd9080280 |
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