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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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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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Myocarditis is inflammation of the myocardium, which is the muscular layer of the heart.EtiologyMyocarditis has a diverse etiology, including a wide range of infectious and non-infectious causes:Infectious CausesViral: Common viruses include Coxsackie A and B, adenovirus, parvovirus B19, enteroviruses, and influenza A.Bacterial: Examples include infections caused by Streptococcus, Staphylococcus, and Mycoplasma species.Rickettsial: Infections like Rocky Mountain spotted fever can result in...
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Unsupervised Clustering of Routine Inflammatory Markers in Cardiogenic Shock Reveals Phenotypic Heterogeneity Without

Song Peng Ang1, Jackson Rajendran2, Yashika Gupta3

  • 1Division of Cardiology, University of Arizona, Tucson, AZ 85724, USA.

Journal of Personalized Medicine
|February 26, 2026
PubMed
Summary

Cardiogenic shock patients show distinct inflammatory profiles, but these inflammatory phenotypes may not predict short-term outcomes. Routine lab data alone has limited use for stratifying risk in these patients.

Keywords:
cardiogenic shockcritical careinflammationneutrophil-to-lymphocyte ratiophenotyping

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Area of Science:

  • Critical Care Medicine
  • Cardiology
  • Immunology

Background:

  • Cardiogenic shock is a complex condition where systemic inflammation impacts patient outcomes.
  • Understanding inflammatory variations is crucial for managing cardiovascular risk.

Purpose of the Study:

  • To identify distinct inflammatory phenotypes in patients with cardiogenic shock.
  • To assess the clinical utility of these phenotypes for short-term risk stratification.

Main Methods:

  • Retrospective analysis of 419 adult patients with cardiogenic shock from the eICU Collaborative Research Database.
  • Utilized principal component analysis and clustering (hierarchical, k-means) on admission hematologic inflammatory indices.
  • Compared clinical characteristics and short-term outcomes between identified inflammatory clusters.

Main Results:

  • Two distinct inflammatory phenotypes were identified.
  • Cluster 1 showed a hyperinflammatory, lymphopenic profile with higher prevalence of chronic kidney disease (CKD) and organ dysfunction.
  • Cluster 2 had lower inflammatory indices and less biochemical derangement. Despite biological differences, short-term outcomes like mortality and acute kidney injury were similar between clusters.

Conclusions:

  • Cardiogenic shock presents with identifiable inflammatory phenotypes.
  • Inflammatory clustering using routine admission labs may have limited value for predicting short-term clinical outcomes in cardiogenic shock.