Evidence map›Paper›PMID 39895206›Full record

Observational studyESC heart failure2025

Validation of a biomarker-based mortality score for cardiogenic shock patients: Comparison with a clinical risk score.

Elina Hynninen, Heli Tolppanen, Mercedes Rivas-Lasarte, Tuukka Tarvasmäki, Veli-Pekka Harjola, Benjamin Deniau, Mari Hongisto, Ewa A Jankowska, Raija Jurkko, Toni Jäntti and 5 more

Abstract readMulticenter StudyObservational StudyValidation Study
In one paragraph

Observational study in ESC heart failure, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Elina HynninenDepartment of Cardiology, Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland.ORCID https://orcid.org/0009-0006-4461-4831
Heli TolppanenDepartment of Cardiology, Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland.
Mercedes Rivas-LasarteDepartment of Cardiology, Hospital Universitario Puerta de Hierro, IDIPHISA, CIBER CV, Majadahonda, Spain.
Tuukka TarvasmäkiDepartment of Cardiology, Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland.
Veli-Pekka HarjolaDepartment of Emergency Medicine, Department of Emergency Medicine and Services, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
Benjamin DeniauDepartment of Anesthesiology, Critical Care and Burn Unit, University Hospitals Saint-Louis-Lariboisière, AP-HP, FHU PROMICE, Paris, France.
Mari HongistoDepartment of Emergency Medicine, Department of Emergency Medicine and Services, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
Ewa A JankowskaInstitute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland, Institute of Heart Diseases, University Hospital in Wroclaw, Wroclaw, Poland Internal Medicine, Helsinki University Hospital, Helsinki, Finland.
Raija JurkkoDepartment of Cardiology, Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland.
Toni JänttiDepartment of Cardiology, Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland.
Anu KatajaInstitute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland, Institute of Heart Diseases, University Hospital in Wroclaw, Wroclaw, Poland Internal Medicine, Helsinki University Hospital, Helsinki, Finland.
Alexandre MebazaaDepartment of Anesthesia & Critical Care, Université Paris Cité, APHP, Inserm MASCOT, FHU PROMICE, Paris, France.
Tuija SabellDepartment of Cardiology, Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland.
Alessandro SionisHospital de la Santa Creu i Sant Pau, Barcelona, Spain and Universitat Autònoma de Barcelona, Barcelona, Spain.
Johan LassusDepartment of Cardiology, Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland.

Funding

Aarne Koskelo FoundationFinska LäkaresällskapetFoundation for Cardiovascular Research
6 · The paper itself

Abstract

aimsCardiogenic shock (CS) is the deadliest manifestation of acute heart failure, with persistently high mortality rates and a lack of recent therapeutic breakthroughs. Accurate risk prediction is crucial in clinical decision-making and the design of future clinical trials. We aimed to validate the CLIP score, a biomarker-based risk score comprising cystatin C, lactate, interleukin-6 and NT-proBNP, for predicting mortality in acute coronary syndrome (ACS) related CS, and to compare its predictive value with the previously published CardShock risk score. METHODS AND

resultsThe study is a post hoc analysis of the CardShock Study, a prospective, observational European multicentre study on CS. The CLIP score was calculated 12 h after hospital admission, and its ability to predict 90-day mortality was assessed using are under the curve (AUC) of the receiver-operating characteristics (ROC) curve analysis. The discriminative ability of the CLIP score was compared with the CardShock risk score by comparing the AUC's. The cohort was dichotomized into low and high risk groups by the optimal cut-off value derived from the ROC analysis of the CLIP score. Kaplan-Meier curves were constructed to evaluate risk stratification when combining the CLIP and CardShock risk scores. The cohort (n = 121) comprised 77% (n = 93) men and the median age was 67 years (IQR 61-76). A total of 21% (n = 25) of the patients had non-ACS related CS. The CLIP score demonstrated appropriate predictive accuracy for 90-day mortality (AUC 0.84, 95% CI 0.77-0.91), comparable with the CardShock risk score (AUC 0.77 [95% CI 0.69-0.85]; P = 0.064 for comparison). A CLIP score cut-off of 0.28 stratified patients into high risk (65% mortality) and low risk (16% mortality) groups. In addition, incorporating the CLIP score enhanced risk stratification in all CardShock risk score categories.

conclusionsThe CLIP score, calculated within 12 h of hospital admission, accurately predicted 90-day mortality in CS and complemented the CardShock risk score. The biomarker-based score has potential utility in dynamic mortality risk assessment and could inform clinical management and trial design.

Indexed as

Natriuretic Peptide, BrainPeptide FragmentsShock, CardiogenicAgedBiomarkersEuropeFemaleFollow-Up StudiesHumansInterleukin-6MaleMiddle AgedPrognosisProspective StudiesRisk AssessmentRisk FactorsBiomarkersInterleukin-6Natriuretic Peptide, BrainPeptide Fragmentspro-brain natriuretic peptide (1-76)BiomarkersCardiogenic shockMortality predictionRisk score

Identifiers

PMID39895206
PMCPMC12055353

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.