Cardiogenic shock (CS) is associated with high short-term mortality and a precise CS risk stratification could guide interventions to improve patient outcome. A 4-protein risk score (CS4P) was derived and validated for 90-day risk of mortality. The CS4P risk score, which comprises proteins Liver-fatty acid-binding protein (L-FABP), Beta-2-microglobulin (B2MG), Fructose-bisphosphate aldolase B (ALDOB), and SerpinG1 (IC1), identified short-term mortality risk with a C-statistic of 0.83 (95% CI 0.74–0.89). CS4P patient classifier performed better than contemporary risk scores. In CS a prompt risk stratification using the CS4P patient classifier guide clinicians in selecting patients for advanced therapies

Candidate biomarker proteins identified in a mass spectrometry discovery phase, were evaluated in terms of classification power in an international validation cohort (Cardshock) with targeted proteomics quantification using parallel reaction monitoring (PRM). Plasma samples corresponding to 97 patients from the CardShock cohort (36 non-survivors and 61 survivors at 90 days), were trypsin digested and analyzed using targeted nLC-PRM and isotopically-labeled standard peptides as internal references. Fragment ion chromatographic traces for all targeted precursor peptides were evaluated, logarithmic transformed, and normalized using the internal reference peptides. Protein relative quantification was assessed between survivors and non-survivors using software packages Skyline 3.716 and MSstats 3.8.2. The classification power of each protein and protein combinations was evaluated by the area under the curve (AUC) of a receiver operating characteristic (ROC) curve.

Patient's blood plasma