Nav: Home

A new tool makes it possible to adapt treatment for patients with cardiogenic shock

June 17, 2019

Cardiogenic shock is a possible complication of serious heart attack involving an associated mortality rate of approximately 50% of all cases

The combination of this new tool with existing methods renders precise and patient-specific decision-making possible

The research is being led by Dr. Antoni Bayés at Germans Trias and the Proteomics Unit of the CRG and UPF, under Dr. Eduard Sabidó

A joint research effort by the Hospital and the Instituto de Investigación Germans Trias i Pujol (IGTP) is characterising and studying a new cohort of cardiogenic shock patients to predict the risk of having this heart attack-derived complication which, while infrequent, sometimes presents a fatal outcome. It is the first molecular study for risk prediction described for this disease and is based on a proteomic meta-analysis that has made it possible to discover biomarkers and validate their use in decision-making. The new method, combined with existing techniques, will help to implement more precise treatments. Moreover, the know-how has been patented and work is under way to transfer it to the immunological techniques widely used in clinical diagnosis, such as ELISA.

The objective of the study was to obtain a reliable method to predict which post-heart attack cardiogenic shock patients have a greater risk of not surviving. Cardiogenic shock is a possible complication of severe infarction in which the heart is suddenly unable to maintain the required blood flow. It does not occur in all heart attack cases, although it is fatal if it goes undetected and is not treated promptly. In this case, the discovery of four proteins that can be used as biomarkers is a new tool which, in conjunction with existing ones, makes it possible to pre-empt this complication more precisely.

The group led by Dr. Antoni Bayés-Genís at the Hospital e Instituto de Investigación Germans Trias i Pujol (CIBER Cardiovascular investigators) and Dr. Eduard Sabidó of the Proteomics Unit (a node of the ICTS OmicsTech and a member of the ProteoRed-ISCIII network) of the Centre for Genomic Regulation (CRG) and the Pompeu Fabra University (UPF), has identified 4 proteins (from more than 2600 analysed) that identify patients with cardiogenic shock and a poor vital prognosis. The work has been published in the European Heart Journal, the leading publication in the cardiovascular field.

"The article demonstrates the complex work of sample collection we conducted for the Barcelona Discovery cohort, following strict and standard criteria that enabled us to use them to perform an in vitro trial in liquid biopsies to prevent death in patients with cardiogenic shock", Dr. Bayés explains. "This type of complication, if detected in time, can be treated specifically in order to restore blood flow. The know-how provided by this new tool will help us to decide the best treatment option on a by-case basis", he continues.

The title of the trial is CS4P, and it is comprised of these 4 proteins, which were discovered with the help of mass spectrometry. "We used a combination of liquid chromatography and mass spectrometry to quantify the proteins present in the cohort samples. It is the first risk-prediction molecular study described for this disease, and the trial has been transferred to ELISA and validated in a European reference cohort", Sabidó adds.

For the first time ever, an integrated quantitative approach combined with proteomics has been used to discover biomarkers and to be validated as a risk assessment tool in patients with this condition, and in which the level of the four proteins involved was compared to two current evaluation methods. "We have discovered that the new method complements existing ones, making them much more reliable," Bayés concludes.

The proteomics aspect of the work also furnished valuable information about the mechanisms that trigger cardiogenic shock, as well as the failure of other organs in critical patients. In other words, they could be valid biomarkers for other types of failure. There are a great many possibilities for extending the use of protein biomarkers in serious patients by means of similar techniques.

One of the next steps will be to fine-tune the ELISA assays for clinical use. A patent application has also been submitted for the use of the CS4P cardiovascular shock risk stratification model for the IGTP, the CRG and the UPF.
-end-


Center for Genomic Regulation

Related Heart Attack Articles:

Muscle protein abundant in the heart plays key role in blood clotting during heart attack
A prevalent heart protein known as cardiac myosin, which is released into the body when a person suffers a heart attack, can cause blood to thicken or clot--worsening damage to heart tissue, a new study shows.
New target identified for repairing the heart after heart attack
An immune cell is shown for the first time to be involved in creating the scar that repairs the heart after damage.
Heart cells respond to heart attack and increase the chance of survival
The heart of humans and mice does not completely recover after a heart attack.
A simple method to improve heart-attack repair using stem cell-derived heart muscle cells
The heart cannot regenerate muscle after a heart attack, and this can lead to lethal heart failure.
Mount Sinai discovers placental stem cells that can regenerate heart after heart attack
Study identifies new stem cell type that can significantly improve cardiac function.
Fixing a broken heart: Exploring new ways to heal damage after a heart attack
The days immediately following a heart attack are critical for survivors' longevity and long-term healing of tissue.
Heart patch could limit muscle damage in heart attack aftermath
Guided by computer simulations, an international team of researchers has developed an adhesive patch that can provide support for damaged heart tissue, potentially reducing the stretching of heart muscle that's common after a heart attack.
How the heart sends an SOS signal to bone marrow cells after a heart attack
Exosomes are key to the SOS signal that the heart muscle sends out after a heart attack.
Heart attack patients taken directly to heart centers have better long-term survival
Heart attack patients taken directly to heart centers for lifesaving treatment have better long-term survival than those transferred from another hospital, reports a large observational study presented today at Acute Cardiovascular Care 2019, a European Society of Cardiology congress.
Among heart attack survivors, drug reduces chances of second heart attack or stroke
In a clinical trial involving 18,924 patients from 57 countries who had suffered a recent heart attack or threatened heart attack, researchers at the University of Colorado Anschutz Medical Campus and fellow scientists around the world have found that the cholesterol-lowering drug alirocumab reduced the chance of having additional heart problems or stroke.
More Heart Attack News and Heart Attack Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Listen Again: Reinvention
Change is hard, but it's also an opportunity to discover and reimagine what you thought you knew. From our economy, to music, to even ourselves–this hour TED speakers explore the power of reinvention. Guests include OK Go lead singer Damian Kulash Jr., former college gymnastics coach Valorie Kondos Field, Stockton Mayor Michael Tubbs, and entrepreneur Nick Hanauer.
Now Playing: Science for the People

#562 Superbug to Bedside
By now we're all good and scared about antibiotic resistance, one of the many things coming to get us all. But there's good news, sort of. News antibiotics are coming out! How do they get tested? What does that kind of a trial look like and how does it happen? Host Bethany Brookeshire talks with Matt McCarthy, author of "Superbugs: The Race to Stop an Epidemic", about the ins and outs of testing a new antibiotic in the hospital.
Now Playing: Radiolab

Dispatch 6: Strange Times
Covid has disrupted the most basic routines of our days and nights. But in the middle of a conversation about how to fight the virus, we find a place impervious to the stalled plans and frenetic demands of the outside world. It's a very different kind of front line, where urgent work means moving slow, and time is marked out in tiny pre-planned steps. Then, on a walk through the woods, we consider how the tempo of our lives affects our minds and discover how the beats of biology shape our bodies. This episode was produced with help from Molly Webster and Tracie Hunte. Support Radiolab today at Radiolab.org/donate.