Abstract 2087: Plasma Interleukin - 6 and Nt-proBNP Levels are Strong and Independent Predictors of Outcome in Patients with Cardiogenic Shock
Introduction: High plasma levels of interleukin - 6 (IL-6) has shown to be associated with multiple organ failure in cardiogenic shock (CS) but its relation to outcome has not been investigated yet. Recent studies reported massively elevated levels of N-terminal pro-B-type natriuretic peptide (Nt-proBNP) in critically ill patients admitted to the intensive care unit. At present, however, little is known about prognostic significance of Nt-proBNP in patients with CS.
Methods: Plasma levels of IL-6 (R&D Systems, Germany) and Nt-proBNP (Roche Diagnostics, Austria) were determined in blood samples of 48 patients collected at admission to the coronary care unit.
Results: Both IL-6 and Nt-proBNP levels were significant predictors of mortality both in univariate (p=0.005 for IL-6 and p=0.009 for Nt-proBNP) as well as in multivariate Cox-regression analyses (p=0.01 and 0.009 respectively). According to ROC analyses IL-6 of 200pg/ml and median of Nt-proBNP had highest predictive value of 30 days mortality. None of the patients with both markers above these respective cut-offs survived more than 15 days, while patients with lower levels of Nt-proBNP and/or IL-6 had significantly better survival (p< 0,001; Figure⇓).
Conclusion: Nt-proBNP and IL-6 levels are strong and independent predictors of outcome in patients with CS. Simultaneous measurements of these markers in the intensive care unit could help for early risk stratification of CS.