Monocyte subsets predict mortality after cardiac arrest

Journal of Leukocyte Biology: An Official Publication of the Reticuloendothelial Society

article

Konstantin A. Krychtiuk¹  Max Lenz¹  Bernhard Richter¹  Philipp. J. Hohensinner¹  Stefan P. Kastl¹  Andreas Mangold¹  Kurt Huber²  Christian Hengstenberg¹  Johann Wojta¹  Gottfried Heinz¹  Walter S. Speidl¹ 

[1] Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna;Ludwig Boltzmann Cluster for Cardiovascular Research;3rd Medical Department, Wilhelminen Hospital;Core Facilities, Medical University of Vienna

关键词: cardiac arrest;    innate immunity;    monocyte subsets;    monocytes;   

DOI  :  10.1002/JLB.5A0420-231RR

学科分类：生理学

来源: Federation of American Societies for Experimental Biology

【 摘 要 】

After successful cardiopulmonary resuscitation (CPR), many patients show signs of an overactive immune activation. Monocytes are a heterogeneous cell population that can be distinguished into 3 subsets by flow cytometry (classical monocytes [CM: CD14 ++ CD16 - ], intermediate monocytes [IM: CD14 ++ CD16 + CCR2 + ] and non-classical monocytes [NCM: CD14 + CD16 ++ CCR2 - ]). Fifty-three patients admitted to the medical intensive care unit (ICU) after cardiac arrest were included. Blood was taken on admission and after 72 h. The primary endpoint of this study was survival at 6 months and the secondary endpoint was neurological outcome as determined by cerebral performance category (CPC)-score at 6 months. Median age was 64.5 (49.8-74.3) years and 75.5% were male. Six-month mortality was 50.9% and survival with good neurological outcome was 37.7%. Monocyte subset distribution upon admission to the ICU did not differ according to survival. Seventy-two hours after admission, patients who died within 6 months showed a higher percentage of the pro-inflammatory subset of IM (8.3% [3.8-14.6]% vs. 4.1% [1.5–8.2]%; P  = 0.025), and a lower percentage of CM (87.5% [79.9–89.0]% vs. 90.8% [85.9–92.7]%; P  = 0.036) as compared to survivors. In addition, IM were predictive of outcome independent of time to ROSC and witnessed cardiac arrest, and correlated with CPC-score at 6 months ( R  = 0.32; P  = 0.043). These findings suggest a possible role of the innate immune system in the pathophysiology of post cardiac arrest syndrome.

【 授权许可】

CC BY