Impact of mild therapeutic hypothermia on plasma markers of inflammation and apoptosis in non-resuscitated patients with acute myocardial infarction and cardiogenic shock
- 03.09.2025
- Original Paper
Erschienen in:
- Verfasst von
- Anne Freund
- Petra Büttner
- Maria Buske
- Janine Pöss
- Hans-Josef Feistritzer
- Steffen Desch
- Georg Fuernau
- Holger Thiele
- Erschienen in
- Clinical Research in Cardiology | Ausgabe 10/2025
Abstract
Background
Patients 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.
Methods
Blood 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.
Results
All 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).
Conclusions
Hypothermia 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.
Graphical Abstract
The graphical abstract was designed using illustrations from Servier Medical Art (https://creativecommons.org/licenses/by/4.0/). Abbreviations: AMI-CS, acute myocardial infarction complicated by cardiogenic shock; IL, interleukin; ICAM1, intercellular adhesion molecule 1; MTH, mild therapeutic hypothermia; sFAS, soluble FAS; sFASL, soluble FAS-ligand; TNF-α, tumor necrosis factor alpha; TNF-R1, TNF-receptor 1; TRAIL-R2, TNF-related apoptosis-inducing ligand receptor 2; VCAM 1, vascular cell adhesion molecule 1
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- Titel
- Impact of mild therapeutic hypothermia on plasma markers of inflammation and apoptosis in non-resuscitated patients with acute myocardial infarction and cardiogenic shock
- Verfasst von
-
Anne Freund
Petra Büttner
Maria Buske
Janine Pöss
Hans-Josef Feistritzer
Steffen Desch
Georg Fuernau
Holger Thiele
- Publikationsdatum
- 03.09.2025
- Verlag
- Springer Berlin Heidelberg
- Erschienen in
-
Clinical Research in Cardiology / Ausgabe 10/2025
Print ISSN: 1861-0684
Elektronische ISSN: 1861-0692 - DOI
- https://doi.org/10.1007/s00392-025-02748-8
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