Association between haemolysis markers and neuron-specific enolase in acute myocardial infarction complicated by cardiogenic shock patients supported with a microaxial flow pump.

IF 3.9 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Zakaria Alaoui-Ismaili, Anika Klein, Jakob Josiassen, Ole Kristian Lerche Helgestad, Karoline Korsholm Jeppesen, Hanne Berg Ravn, Jesper Kjærgaard, Christian Hassager, Jacob Eifer Møller
{"title":"Association between haemolysis markers and neuron-specific enolase in acute myocardial infarction complicated by cardiogenic shock patients supported with a microaxial flow pump.","authors":"Zakaria Alaoui-Ismaili, Anika Klein, Jakob Josiassen, Ole Kristian Lerche Helgestad, Karoline Korsholm Jeppesen, Hanne Berg Ravn, Jesper Kjærgaard, Christian Hassager, Jacob Eifer Møller","doi":"10.1093/ehjacc/zuaf003","DOIUrl":null,"url":null,"abstract":"<p><strong>Aims: </strong>Acute myocardial infarction complicated by cardiogenic shock (AMICS) is frequently preceded by out-of-hospital cardiac arrest (OHCA), with risk of anoxic brain injury. Neuron-specific enolase (NSE) is central to neuroprognostication; however, concomitant haemolysis can increase NSE independent of neuronal injury due to the presence of NSE in erythrocytes. This consideration is critical in AMICS patients treated with a microaxial flow pump (Impella, Abiomed, Danvers, MA, USA), where haemolysis is frequent.</p><p><strong>Methods and results: </strong>We identified consecutive AMICS patients receiving microaxial flow pump support ≥6 h from 2014 to 2022 in a tertiary Danish heart centre. Peak NSE and haemolysis biomarkers within 72 h following microaxial flow pump placement were used for analysis. Haemolysis was defined as plasma-free haemoglobin levels >31.5 µmol/L within 72 h from device placement. The population was stratified according to the presence or absence of haemolysis. The final study population comprised 44 patients with eligible NSE and haemolysis biomarkers. The median NSE was 85 µg/L. Patients with haemolysis had significantly higher NSE levels than those without (115 vs. 69 µg/L, P = 0.018). Neuron-specific enolase levels were similar between OHCA and non-OHCA patients. No significant difference in death from anoxic brain injury was observed between patients with NSE levels above and below 60 µg/L. Neuron-specific enolase revealed a significantly moderate correlation with all investigated haemolysis markers.</p><p><strong>Conclusion: </strong>Neuron-specific enolase was associated with haemolysis, and not anoxic brain injury, in AMICS patients supported with a microaxial flow pump.</p>","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"169-172"},"PeriodicalIF":3.9000,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Heart Journal: Acute Cardiovascular Care","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/ehjacc/zuaf003","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0

Abstract

Aims: Acute myocardial infarction complicated by cardiogenic shock (AMICS) is frequently preceded by out-of-hospital cardiac arrest (OHCA), with risk of anoxic brain injury. Neuron-specific enolase (NSE) is central to neuroprognostication; however, concomitant haemolysis can increase NSE independent of neuronal injury due to the presence of NSE in erythrocytes. This consideration is critical in AMICS patients treated with a microaxial flow pump (Impella, Abiomed, Danvers, MA, USA), where haemolysis is frequent.

Methods and results: We identified consecutive AMICS patients receiving microaxial flow pump support ≥6 h from 2014 to 2022 in a tertiary Danish heart centre. Peak NSE and haemolysis biomarkers within 72 h following microaxial flow pump placement were used for analysis. Haemolysis was defined as plasma-free haemoglobin levels >31.5 µmol/L within 72 h from device placement. The population was stratified according to the presence or absence of haemolysis. The final study population comprised 44 patients with eligible NSE and haemolysis biomarkers. The median NSE was 85 µg/L. Patients with haemolysis had significantly higher NSE levels than those without (115 vs. 69 µg/L, P = 0.018). Neuron-specific enolase levels were similar between OHCA and non-OHCA patients. No significant difference in death from anoxic brain injury was observed between patients with NSE levels above and below 60 µg/L. Neuron-specific enolase revealed a significantly moderate correlation with all investigated haemolysis markers.

Conclusion: Neuron-specific enolase was associated with haemolysis, and not anoxic brain injury, in AMICS patients supported with a microaxial flow pump.

微轴流泵支持下AMICS患者溶血标志物与神经元特异性烯醇化酶之间的关系
背景:急性心肌梗死合并心源性休克(AMICS)经常发生院外心脏骤停(OHCA),有缺氧脑损伤的风险。神经元特异性烯醇化酶(NSE)是神经预后的核心;然而,由于NSE存在于红细胞中,伴随的溶血可以增加NSE,而不依赖于神经元损伤。对于使用微轴流泵(Impella, Abiomed)治疗的AMICS患者来说,这一点至关重要,因为这些患者经常发生溶血。方法和结果:我们确定了2014年至2022年在丹麦三级心脏中心连续接受微轴流泵支持≥6小时的AMICS患者。使用微轴流泵放置后72h内的峰值NSE和溶血生物标志物进行分析。溶血定义为装置放置后72h内血浆游离血红蛋白水平bb0 31.5µmol/L。根据溶血的存在与否对人群进行分层。最终的研究人群包括44例符合条件的NSE和溶血生物标志物患者。平均NSE为85µg/L。溶血患者的NSE水平显著高于无溶血患者(115 vs 69µg/L, p=0.018)。OHCA和非OHCA患者的NSE水平相似。NSE水平高于或低于60µg/L的患者死于缺氧脑损伤的概率无显著差异。NSE与所有研究的溶血标志物均显示出显著的中度相关性。结论:在微轴流泵支持下的AMICS患者中,NSE与溶血有关,而非缺氧性脑损伤。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
8.50
自引率
4.90%
发文量
325
期刊介绍: The European Heart Journal - Acute Cardiovascular Care (EHJ-ACVC) offers a unique integrative approach by combining the expertise of the different sub specialties of cardiology, emergency and intensive care medicine in the management of patients with acute cardiovascular syndromes. Reading through the journal, cardiologists and all other healthcare professionals can access continuous updates that may help them to improve the quality of care and the outcome for patients with acute cardiovascular diseases.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信