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A CD36-based prediction model for sepsis-induced myocardial injury
Yun Xie1, Hui Lv1, Daonan Chen1
1Department of Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Songjiang, Shanghai 201600, PR China.
Insights
Elevated CD36 levels are a significant risk factor for sepsis-induced myocardial injury (SIMI) and mortality. A new predictive model using CD36 and age shows promise for identifying patients at risk of SIMI.
Area of Science:
- Cardiology
- Intensive Care Medicine
- Biomarker Research
Background:
- Sepsis-induced myocardial injury (SIMI) is a common complication in sepsis patients, contributing to increased mortality.
- Early identification and prediction of SIMI are crucial for improving patient outcomes.
Purpose of the Study:
- To develop a predictive model for SIMI utilizing plasma CD36 levels.
- To investigate the association between CD36 levels and mortality in sepsis patients.
Main Methods:
- A prospective study was conducted on sepsis patients admitted to the ICU.
- Plasma CD36 levels were measured within 48 hours of ICU admission.
- A predictive model for SIMI was developed using logistic regression analysis.
Main Results:
- Elevated plasma CD36 levels and older age were identified as significant risk factors for SIMI.
- CD36, THBS1, and BNP were independent mortality risk factors.
- The developed predictive model demonstrated good discrimination and calibration (AUC = 0.7724).
Conclusions:
- Elevated CD36 levels are an independent risk factor for SIMI and mortality in sepsis.
- The predictive model incorporating CD36 levels can aid in assessing SIMI risk and prognosis.
Background:
Sepsis-induced myocardial injury (SIMI) is a prevalent form of organ dysfunction with a significant impact on the mortality rate among sepsis patients. This study aims to develop a predictive model for SIMI using plasma CD36 levels.
Methods:
A prospective study was conducted from January 1, 2023, to December 1, 2023, involving sepsis patients admitted to the Department of Intensive Care Medicine at Shanghai General Hospital. Plasma CD36 levels were measured within 48 h of ICU admission, prior to the diagnosis of sepsis-associated myocardial injury. Myocardial damage was assessed using troponin levels.
Results:
Two significant risk factors for SIMI were identified: age and elevated CD36 levels. CD36, THBS1, and BNP were determined to be independent mortality risk factors. The myocardial injury group exhibited higher plasma CD36 levels compared to the non-injury group. Additionally, the deceased group had higher plasma CD36 levels than the survivors. No significant differences in CD36 levels were observed between groups with lung and stomach infections or between Gram-positive and Gram-negative infection groups. Similarly, there was no statistically significant difference in CD36 levels between surgical and medical patients. A predictive model for SIMI was formulated as follows: ln [P/(1-P)] = -0.000818age + 0.4975756CD36 - 5.400293. The model's quality of fit was tested with a P-value of 0.4682, indicating a good degree of discrimination and calibration, as evidenced by the area under the ROC curve (0.7724).
Conclusion:
The prognosis of individuals with sepsis is closely associated with elevated CD36 levels. Elevated CD36 is identified as an independent risk factor for both SIMI and mortality in sepsis patients. The predictive model suggests that high CD36 levels are indicative of SIMI and are associated with a poor prognosis.
