%0 Journal Article %1 Ceglarek2021-jb %A Ceglarek, Uta %A Schellong, Paul %A Rosolowski, Maciej %A Scholz, Markus %A Willenberg, Anja %A Kratzsch, Jürgen %A Zeymer, Uwe %A Fuernau, Georg %A de Waha-Thiele, Suzanne %A Büttner, Petra %A Jobs, Alexander %A Freund, Anne %A Desch, Steffen %A Feistritzer, Hans-Josef %A Isermann, Berend %A Thiery, Joachim %A Pöss, Janine %A Thiele, Holger %D 2021 %I Oxford University Press (OUP) %J Eur. Heart J. %K Biomarker; Cardiogenic Myocardial Prognosis; Score; infarction; shock %N 24 %P 2344--2352 %T The novel cystatin C, lactate, interleukin-6, and N-terminal pro-B-type natriuretic peptide (CLIP)-based mortality risk score in cardiogenic shock after acute myocardial infarction %V 42 %X BACKGROUND: Cardiogenic shock (CS) complicating acute myocardial infarction (AMI) still reaches excessively high mortality rates. This analysis is aimed to develop a new easily applicable biomarker-based risk score. METHODS AND RESULTS: A biomarker-based risk score for 30-day mortality was developed from 458 patients with CS complicating AMI included in the randomized CULPRIT-SHOCK trial. The selection of relevant predictors and the coefficient estimation for the prognostic model were performed by a penalized multivariate logistic regression analysis. Validation was performed internally, internally externally as well as externally in 163 patients with CS included in the randomized IABP-SHOCK II trial. Blood samples were obtained at randomization. The two trials are registered with ClinicalTrials.gov (NCT01927549 and NCT00491036), are closed to new participants, and follow-up is completed. Out of 58 candidate variables, the four strongest predictors for 30-day mortality were included in the CLIP score (cystatin C, lactate, interleukin-6, and N-terminal pro-B-type natriuretic peptide). The score was well calibrated and yielded high c-statistics of 0.82 95\% confidence interval (CI) 0.78-0.86 in internal validation, 0.82 (95\% CI 0.75-0.89) in internal-external (temporal) validation, and 0.73 (95\% CI 0.65-0.81) in external validation. Notably, it outperformed the Simplified Acute Physiology Score II and IABP-SHOCK II risk score in prognostication (0.83 vs 0.62; P < 0.001 and 0.83 vs. 0.76; P = 0.03, respectively). CONCLUSIONS: A biomarker-only score for 30-day mortality risk stratification in infarct-related CS was developed, extensively validated and calibrated in a prospective cohort of contemporary patients with CS after AMI. The CLIP score outperformed other clinical scores and may be useful as an early decision tool in CS.

@article{Ceglarek2021-jb, abstract = {BACKGROUND: Cardiogenic shock (CS) complicating acute myocardial infarction (AMI) still reaches excessively high mortality rates. This analysis is aimed to develop a new easily applicable biomarker-based risk score. METHODS AND RESULTS: A biomarker-based risk score for 30-day mortality was developed from 458 patients with CS complicating AMI included in the randomized CULPRIT-SHOCK trial. The selection of relevant predictors and the coefficient estimation for the prognostic model were performed by a penalized multivariate logistic regression analysis. Validation was performed internally, internally externally as well as externally in 163 patients with CS included in the randomized IABP-SHOCK II trial. Blood samples were obtained at randomization. The two trials are registered with ClinicalTrials.gov (NCT01927549 and NCT00491036), are closed to new participants, and follow-up is completed. Out of 58 candidate variables, the four strongest predictors for 30-day mortality were included in the CLIP score (cystatin C, lactate, interleukin-6, and N-terminal pro-B-type natriuretic peptide). The score was well calibrated and yielded high c-statistics of 0.82 [95\% confidence interval (CI) 0.78-0.86] in internal validation, 0.82 (95\% CI 0.75-0.89) in internal-external (temporal) validation, and 0.73 (95\% CI 0.65-0.81) in external validation. Notably, it outperformed the Simplified Acute Physiology Score II and IABP-SHOCK II risk score in prognostication (0.83 vs 0.62; P < 0.001 and 0.83 vs. 0.76; P = 0.03, respectively). CONCLUSIONS: A biomarker-only score for 30-day mortality risk stratification in infarct-related CS was developed, extensively validated and calibrated in a prospective cohort of contemporary patients with CS after AMI. The CLIP score outperformed other clinical scores and may be useful as an early decision tool in CS.}, added-at = {2024-09-10T11:54:51.000+0200}, author = {Ceglarek, Uta and Schellong, Paul and Rosolowski, Maciej and Scholz, Markus and Willenberg, Anja and Kratzsch, J{\"u}rgen and Zeymer, Uwe and Fuernau, Georg and de Waha-Thiele, Suzanne and B{\"u}ttner, Petra and Jobs, Alexander and Freund, Anne and Desch, Steffen and Feistritzer, Hans-Josef and Isermann, Berend and Thiery, Joachim and P{\"o}ss, Janine and Thiele, Holger}, biburl = {https://puma.scadsai.uni-leipzig.de/bibtex/22deb981accc02c0388771bea01562726/scadsfct}, copyright = {https://academic.oup.com/journals/pages/open\_access/funder\_policies/chorus/standard\_publication\_model}, interhash = {182a9c13caf42adc56ef7161bc432d87}, intrahash = {2deb981accc02c0388771bea01562726}, journal = {Eur. Heart J.}, keywords = {Biomarker; Cardiogenic Myocardial Prognosis; Score; infarction; shock}, language = {en}, month = jun, number = 24, pages = {2344--2352}, publisher = {Oxford University Press (OUP)}, timestamp = {2024-09-10T11:54:51.000+0200}, title = {The novel cystatin C, lactate, interleukin-6, and N-terminal pro-B-type natriuretic peptide ({CLIP)-based} mortality risk score in cardiogenic shock after acute myocardial infarction}, volume = 42, year = 2021 }