In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled. For optimal viewing of this site, please ensure that Javascript is enabled for your browser.

The free consultation period for this content is over.

It is now only available year-round to ACVC Ivory (& above) Members, Fellows of the ESC and Young combined Members

Monocyte subset distribution is associated with mortality of critically ill patients

Session Inflammation and atherothrombosis in ACS

Speaker Konstantin A Krychtiuk

Event : Acute Cardiovascular Care 2015

  • Topic : basic science
  • Sub-topic : Basic Science
  • Session type : Symposium

Authors : KA Krychtiuk (Vienna,AT), M Lenz (Vienna,AT), L Wutzlhofer (Vienna,AT), K Huber (Vienna,AT), G Maurer (Vienna,AT), G Heinz (Vienna,AT), J Wojta (Vienna,AT), WS Speidl (Vienna,AT)

Authors:
KA Krychtiuk1 , M Lenz1 , L Wutzlhofer1 , K Huber2 , G Maurer1 , G Heinz1 , J Wojta1 , WS Speidl1 , 1Medical University of Vienna, Department of Internal Medicine II, Division of Cardiology - Vienna - Austria , 2Wilhelminen Hospital, 3rd Department of Internal Medicine, Cardiology and Emergency Medicine - Vienna - Austria ,

Citation:
European Heart Journal: Acute Cardiovascular Care ( 2015 ) 4 ( Supplement 5 ), S140

Purpose: Despite the fact that patients admitted to an ICU suffer from various pathologies, many develop a systemic inflammatory response syndrome (SIRS). As key regulators of innate immunity, monocytes may be crucially involved in SIRS development. Monocytes can be distinguished into three subsets: Classical monocytes (CD14++CD16-; CM), non-classical monocytes (CD14+CD16++; NCM) and intermediate monocytes (CD14++CD16+; IM), the latter shown to be particularly pro-inflammatory. The aim of our present study was to analyze whether monocyte subset distribution at admission or 72 hours after admission in critically ill patients is associated with 30-day survival.
Methods: In this prospective, observational study, 195 consecutive patients admitted to a cardiac ICU at a tertiary care center were enrolled. Blood was taken at admission and after 72 hours. Distribution of monocyte subsets was analyzed by flow-cytometry.
Results: Mean Apache II score was 19.5±8.1 and 30-day mortality was 25.4%. At admission, NCM were significantly lower in non-survivors as compared to survivors [2.65 (0.42-5.53) vs. 4.36 (0.67-7.66) %; p=0.010] whereas CM and IM did not differ according to 30-day survival. In contrast, 72 hours after admission, monocyte subset distribution shifted towards an increased proportion of IM [9.4 (3.8-13.1) vs. 4.3 (2.3-8.1); p=0.005] with a concomitant decrease of CM [86.8 (78.5-89.3) vs. 89.6 (84.9-93.1); p=0.009] in non-survivors versus survivors, respectively. NCM at day 3 were not associated with death at 30 days. Kaplan Meier analysis revealed that NCM at admission below the median predicted early mortality (day 0 to day 10; p<0.001), whereas CM and IM at day 3 were associated with late mortality (CM: p=0.036; IM: p=0.003).
Conlusions: Circulating monocyte subsets are associated with 30-day mortality in critically ill patients. The innate immune system as reflected by monocyte subset distribution plays a major role in ICU outcome despite varying admittance pathologies.

The free consultation period for this content is over.

It is now only available year-round to ACVC Ivory (& above) Members, Fellows of the ESC and Young combined Members

Members get more

Join now
  • 1ESC Professional Members – access all resources from general ESC events 
  • 2ESC Association Members (Ivory, Silver, Gold) – access your Association’s resources
  • 3Under 40 or in training - with a Combined Membership, access all resources
Join now

Our sponsors

ESC 365 is supported by Bayer, Boehringer Ingelheim and Lilly Alliance, Bristol-Myers Squibb and Pfizer Alliance, Novartis Pharma AG and Vifor Pharma in the form of educational grants. The sponsors were not involved in the development of this platform and had no influence on its content.

logo esc

Our mission: To reduce the burden of cardiovascular disease

Who we are