Protein-based cardiogenic shock patient classifier

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Rueda , F , Borras , E , Garcia-Garcia , C , Iborra-Egea , O , Revuelta-Lopez , E , Harjola , V-P , Cediel , G , Lassus , J , Tarvasmäki , T , Mebazaa , A , Sabido , E & Bayes-Genis , A 2019 , ' Protein-based cardiogenic shock patient classifier ' , European Heart Journal , vol. 40 , no. 32 , pp. 2684-2694 .

Title: Protein-based cardiogenic shock patient classifier
Author: Rueda, Ferran; Borras, Eva; Garcia-Garcia, Cosme; Iborra-Egea, Oriol; Revuelta-Lopez, Elena; Harjola, Veli-Pekka; Cediel, German; Lassus, Johan; Tarvasmäki, Tuukka; Mebazaa, Alexandre; Sabido, Eduard; Bayes-Genis, Antoni
Contributor organization: HUS Emergency Medicine and Services
Department of Diagnostics and Therapeutics
University of Helsinki
HUS Heart and Lung Center
Kardiologian yksikkö
Date: 2019-08-21
Language: eng
Number of pages: 11
Belongs to series: European Heart Journal
ISSN: 0195-668X
Abstract: Aims Cardiogenic shock (CS) is associated with high short-term mortality and a precise CS risk stratification could guide interventions to improve patient outcome. Here, we developed a circulating protein-based score to predict short-term mortality risk among patients with CS. Methods and results Mass spectrometry analysis of 2654 proteins was used for screening in the Barcelona discovery cohort (n = 48). Targeted quantitative proteomics analyses (n = 51 proteins) were used in the independent CardShock cohort (n = 97) to derive and cross-validate the protein classifier. The combination of four circulating proteins (Cardiogenic Shock 4 proteins-CS4P), discriminated patients with low and high 90-day risk of mortality. CS4P comprises the abundances of liver-type fatty acid-binding protein, beta-2-microglobulin, fructose-bisphosphate aldolase B, and SerpinG1. Within the CardShock cohort used for internal validation, the C-statistic was 0.78 for the CardShock risk score, 0.83 for the CS4P model, and 0.84 (P = 0.033 vs. CardShock risk score) for the combination of CardShock risk score with the CS4P model. The CardShock risk score with the CS4P model showed a marked benefit in patient reclassification, with a net reclassification improvement (NRI) of 0.49 (P = 0.020) compared with CardShock risk score. Similar reclassification metrics were observed in the IABP-SHOCK II risk score combined with CS4P (NRI =0.57; P = 0.032). The CS4P patient classification power was confirmed by enzyme-linked immuno-sorbent assay (ELISA). Conclusion A new protein-based CS patient classifier, the CS4P, was developed for short-term mortality risk stratification. CS4P improved predictive metrics in combination with contemporary risk scores, which may guide clinicians in selecting patients for advanced therapies.
Subject: Cardiogenic shock
90 days
3121 General medicine, internal medicine and other clinical medicine
Peer reviewed: Yes
Usage restriction: openAccess
Self-archived version: publishedVersion

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