International journal of cardiology · 2025
Insulin-like growth factor binding protein 2 (IGFBP-2) as prognostic parameter in infarct-related cardiogenic shock.
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Masyuk Maryna, Wernly Bernhard, Kelm Malte, Freund Anne, Pöss Janine, Desch Steffen, Schneider Steffen, Akin Ibrahim, Fürnau Georg, Ceglarek Uta, Schemmelmann Mara, Isermann Berend, Gerdes Norbert, Schrage Benedikt, Zeymer Uwe, Büttner Petra, Thiele Holger, Jung Christian
Аннотация
BACKGROUND: Cardiogenic shock (CS) caused by acute myocardial infarction (AMI) is a critical condition with high mortality rate. Insulin-like growth factor binding protein 2 (IGFBP-2) is dysregulated in cardiovascular diseases. The purpose of the present study was to investigate the prognostic value of IGFBP-2 in patients with AMI-CS.
METHODS: This study is a post-hoc analysis of the randomized multicentre CULPRIT-SHOCK trial. IGFBP-2 levels were measured in serum samples from 423 patients using commercially available enzyme-linked immunosorbent assay (ELISA) kits. Associations of IGFBP-2 with 30-day and one-year mortality were investigated.
RESULTS: Median IGFBP-2 concentration was 415 ng/ml (IQR 274-699 ng/ml). Patients with IGFBP-2 ≥ median demonstrated higher 30-day (54 % vs. 37 %; p < 0.001) and one-year mortality (60 % vs. 42 %; p < 0.001) compared to the < median group. Higher IGFBP-2 concentrations were associated with increased 30-day and one-year mortality, irrespective of it being analysed as continuous or categorical variable (per 100 ng/ml IGFBP-2, hazard ratio (HR) 1.06; 95 % confidence interval (CI) 1.04-1.09; p < 0.001, respectively; IGFBP-2 ≥ vs. < median, HR 1.70, 95 % CI 1.23-2.35, p = 0.001 and HR 1.72, 95 %CI 1.27-2.33, p < 0.001). Furthermore, IGFBP-2 ≥ median was associated with increased 30-day (HR 1.70; 95 %CI 1.23-2.35; p = 0.001) and one-year mortality (HR 1.72; 95 %CI 1.27-2.33; p < 0.001), even after adjustment for established prognostic factors.
CONCLUSIONS: In AMI-CS, elevated levels of IGFBP-2 were associated with higher mortality at 30 days and one year after admission. IGFBP-2 represents a promising prognostic biomarker and could add value to risk stratification in this high-risk patient cohort, potentially informing early clinical decision-making.
METHODS: This study is a post-hoc analysis of the randomized multicentre CULPRIT-SHOCK trial. IGFBP-2 levels were measured in serum samples from 423 patients using commercially available enzyme-linked immunosorbent assay (ELISA) kits. Associations of IGFBP-2 with 30-day and one-year mortality were investigated.
RESULTS: Median IGFBP-2 concentration was 415 ng/ml (IQR 274-699 ng/ml). Patients with IGFBP-2 ≥ median demonstrated higher 30-day (54 % vs. 37 %; p < 0.001) and one-year mortality (60 % vs. 42 %; p < 0.001) compared to the < median group. Higher IGFBP-2 concentrations were associated with increased 30-day and one-year mortality, irrespective of it being analysed as continuous or categorical variable (per 100 ng/ml IGFBP-2, hazard ratio (HR) 1.06; 95 % confidence interval (CI) 1.04-1.09; p < 0.001, respectively; IGFBP-2 ≥ vs. < median, HR 1.70, 95 % CI 1.23-2.35, p = 0.001 and HR 1.72, 95 %CI 1.27-2.33, p < 0.001). Furthermore, IGFBP-2 ≥ median was associated with increased 30-day (HR 1.70; 95 %CI 1.23-2.35; p = 0.001) and one-year mortality (HR 1.72; 95 %CI 1.27-2.33; p < 0.001), even after adjustment for established prognostic factors.
CONCLUSIONS: In AMI-CS, elevated levels of IGFBP-2 were associated with higher mortality at 30 days and one year after admission. IGFBP-2 represents a promising prognostic biomarker and could add value to risk stratification in this high-risk patient cohort, potentially informing early clinical decision-making.