Trial reportClinical research in cardiology : official journal of the German Cardiac Society2025
Impact of mild therapeutic hypothermia on plasma markers of inflammation and apoptosis in non-resuscitated patients with acute myocardial infarction and cardiogenic shock.
Trial report in Clinical research in cardiology : official journal of the German Cardiac Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Not yet cited in PubMed.
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Corrections and comments
- Erratum issued
Authors and funding
8 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundPatients with cardiogenic shock (CS) following acute myocardial infarction (AMI) are challenged by pro-inflammatory and pro-apoptotic cellular processes. Little is known about the effect of mild therapeutic hypothermia (MTH) on these alterations.
methodsBlood plasma from 40 patients included in the randomized SHOCK-COOL trial, which compared MTH (33 °C) versus no hypothermia in AMI-CS without cardiac arrest, from the first 3 days of hospitalization was used to determine interleukins (IL)-6 and IL-1β, tumor necrosis factor-alpha (TNF-α), intercellular and vascular soluble adhesion molecules (ICAM1 and VCAM1), TNF-receptor 1 (TNF-R1), TNF-related apoptosis-inducing ligand receptor 2 (TRAIL-R2), soluble FAS-ligand (sFASL), and soluble FAS (sFAS). These markers were also determined in 11 healthy controls.
resultsAll markers except for TNF-R1 and sFASL reached their highest levels on day two or day three in both CS groups. IL-1β and sFAS reached higher maximum levels in the MTH group. IL-1β was higher in the MTH group on day 2 (+ 38%, p = 0.014) and on day 3 (+ 9%, p = 0.047), but the averaged group-wise individual maxima were comparable (24 [17-30] versus 20 [12-25], p = 0.138). The pro-apoptotic marker sFAS was also higher in the MTH group on day 2 (+ 85%, p = 0.004) and day 3 (+ 170%, p < 0.001); the averaged individual maxima were significantly higher in the MTH group (25 [15-38] versus 15 [10-21] ng/ml, p = 0.008).
conclusionsHypothermia in AMI-CS without cardiac arrest has no moderating effect on the assessed pro-inflammatory cytokines. However, sFAS showed significantly higher individual peak maxima in the MTH group indicating enhancement of pro-apoptotic mechanisms via the soluble FAS/FASL pathway.
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