C-Reactive Protein as a Prognostic Biomarker in Infarct-Related Cardiogenic Shock: Insights from the ECLS-SHOCK Trial

Acute myocardial infarction complicated by cardiogenic shock (AMI-CS) remains a critical clinical challenge with high morbidity and mortality rates despite advances in reperfusion and supportive therapies. Systemic inflammation is increasingly recognized as a key pathophysiological component influencing outcomes in AMI-CS, yet the precise impact of inflammatory biomarkers such as C-reactive protein (CRP) on prognosis remains debated. The ECLS-SHOCK trial, a multicenter randomized study, provides a comprehensive dataset to evaluate the prognostic significance of CRP and the efficacy of extracorporeal life support (ECLS) in this patient population.

Study Design

The ECLS-SHOCK trial enrolled 417 patients with infarct-related cardiogenic shock between June 2019 and November 2022 across 44 centers. Inclusion criteria focused on patients undergoing planned revascularization. This population was rigorously assessed for inflammatory marker levels, timing of hospital admission, and subsequent outcomes. The primary endpoint was 30-day all-cause mortality. Additional endpoints included bleeding complications, neurological outcomes, and quality of life at 1 year. Substudies analyzed the prognostic implications of admission timing and baseline CRP levels, along with stratified analysis of ECLS deployment.