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Cardiac biomarkers are critical in diagnosing, prognosing, and managing cardiovascular diseases. Routine measurement of specific biomarkers such as B-type natriuretic peptide (BNP), C-reactive protein (CRP), and homocysteine (Hcy) is common practice in clinical settings to evaluate heart function and predict cardiovascular events.
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Cardiac biomarkers are enzymes, proteins, and hormones released into the blood when cardiac cells are injured. They are powerful tools for triaging.
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Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
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The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
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Pericarditis is distinguished by inflammation of the pericardium, the fibrous sac that encases the heart. It can be acute, lasting less than six weeks, or chronic, persisting for over three months. Understanding its clinical manifestations and diagnostic findings is crucial for timely and effective management.Clinical ManifestationsWhile pericarditis can be asymptomatic, it usually presents with characteristic symptoms such as:Chest Pain: The most characteristic symptom of pericarditis is chest...
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Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
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C-Reactive Protein and White Blood Cell Count in Cardiogenic Shock.

Jonas Dudda1,2, Tobias Schupp1,2, Jonas Rusnak1,2

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White blood cell (WBC) count on admission and C-reactive protein (CRP) levels during treatment predict 30-day mortality in cardiogenic shock (CS) patients. A CRP increase of 200% from day 1 to day 3 indicates higher mortality risk.

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Area of Science:

  • Cardiology
  • Intensive Care Medicine
  • Biomarker Research

Background:

  • Cardiogenic shock (CS) is a critical condition with high mortality.
  • Prognostic data on inflammatory biomarkers in CS patients are limited.
  • Early identification of high-risk CS patients is crucial for timely intervention.

Purpose of the Study:

  • To investigate the prognostic impact of C-reactive protein (CRP) and white blood cell (WBC) counts on 30-day mortality in CS patients.
  • To evaluate the predictive value of serial CRP measurements during intensive care unit (ICU) stay.

Main Methods:

  • Retrospective analysis of 240 consecutive CS patients admitted to a cardiac ICU from 2019 to 2021.
  • Laboratory measurements (CRP, WBC) collected on days 1, 2, 3, 4, and 8.
  • Statistical analyses included C-statistics, Kaplan-Meier, and Cox regression to assess 30-day all-cause mortality.

Main Results:

  • Overall 30-day mortality was 55%.
  • WBC count on admission (AUC=0.605) and CRP levels on days 3-8 (AUC=0.623-0.754) predicted 30-day mortality.
  • A CRP increase ≥200% from day 1 to day 3 significantly elevated mortality risk (HR=1.720).

Conclusions:

  • Admission WBC count and serial CRP levels are valuable prognostic markers in CS.
  • A significant increase in CRP during the early ICU course is associated with increased 30-day mortality.
  • This study provides novel insights into the prognostic utility of inflammatory biomarkers in a broad CS patient cohort.