Biomarkers in cardiogenic shock

Abstract

Biomarkers are useful for diagnosis, disease monitoring and risk stratification in cardiovascular disease. Cardiogenic shock (CS) is a medical emergency caused by a primary cardiac insult resulting in inadequate cardiac output, hypoperfusion and organ injury. The pathophysiology of CS is complex involving hemodynamic and circulatory disturbances, inflammation and organ dysfunction. CS is associated with high short-term mortality. Biomarkers such as lactate, cardiac troponins and markers of renal function are established in the diagnosis and monitoring of CS. Evaluation of organ injury and dysfunction is essential for the management. Biomarkers of inflammation and novel biomarkers such as growth differentiating factor-15 (GDF-15), sST2 and dipeptidyl dipeptidase 3 (DPP) may improve our understanding of pathophysiology and clinical course. The prognostic properties of these biomarkers aids in risk stratification and are incorporated as clinical tools for mortality risk prediction in CS. In this review, the role of biomarkers in CS will be discussed. Markers of organ injury and dysfunction, metabolism and novel biomarkers will be covered from a clinical perspective.

Keywords: Acute kidney injury; Biomarkers; Cardiogenic shock; Inflammation; Lactate; Liver injury; Organ injury; Prognosis.