Evaluation of IL-33R and Galectin-3 as New Biomarkers of Cardiac Damage after Polytrauma-Association with Cardiac Comorbidities and Risk Factors

Abstract

Polytrauma is one of the disorders with the greatest economic impact on healthcare in society and one predictor for poor outcome is cardiac damage. Interleukin 33 receptors (IL-33R) and galectin-3 are two new potential cardiac trauma biomarkers that are the subjects of this investigation. Additionally, this study assesses pre-existing cardiac damage or risk factors as predictors of cardiac damage after polytrauma. This retrospective study includes 107 polytraumatized patients with an ISS ≥16 admitted in a Level 1 Trauma Centre. Plasma samples were taken at admission. IL-33R and galectin-3 concentrations were detected in plasma samples by ELISA. Both did not correlate with the cardiac damage measured by troponin. Next to troponin, IL-33R was increased in patients with pre-existing cardiac comorbidities. In the subgroup of patients with cardiac comorbidities, the BMI and the initial blood sugar level were significantly increased compared to patients without cardiac comorbidities. Galectin-3 and IL-33R were shown to not correlate with cardiac damage. However, our data suggests that IL-33R protein should be revised in future studies as a marker of cardiac comorbidities. Further, our data indicate that patients with cardiac comorbidities represent a separate group of polytrauma patients characterized by higher concentrations of troponin, IL-33R, BMI and initial sugar level.

Keywords: IL-33 receptor; biomarker; cardiac damage; cardiac risk factors; comorbidities; galectin-3; polytrauma.

Figure 1

Relationship among ISS, IL-6, need in catecholamines and patient outcome with plasma troponin T. (A) Injury severity score (ISS) in the troponin subgroups of patients. (B) IL-6 concentration in the troponin subgroups. (C) Time on intensive care unit/intermediate care in days in the troponin subgroups. (D) Ventilation time in days in the troponin subgroups. (E) Troponin T concentrations in patients with (yes) and without (no) need in catecholamines. (F) Table 2 Troponin concentrations in survivors and in non-survivors. (G) Correlation analysis between troponin T and IL-6 measurements. (H) Correlation analysis between troponin T level and the ISS. n = 107 patients, * p ≤ 0.05, ** p ≤ 0.01; *** p ≤ 0.001; **** p ≤ 0.0001.

Figure 2

Interleukin 33 receptor (IL-33R) level in different groups of polytrauma patients. (A) IL-33R concentration in different troponin T patient subgroups. (B) IL-33R concentration in survivors and non-survivors. (C) IL-33R concentration in patients with (yes) and without (no) need in catecholamines. (D) IL-33R concentrations in patients with and without cardiac comorbidities. (E) Correlation analysis between IL-33R and IL-6 plasma concentrations. (F) Correlation analysis between IL-33R plasma concentrations and the injury severity score (ISS). n = 107 patients, ** p ≤ 0.01; *** p ≤ 0.001.

Figure 3

Galectin-3 concentration in different groups of polytrauma patients. (A) Galectin 3 concentration in the troponin T patients’ subgroups (≤12 pg/mL; between 13–49 pg/mL and ≥50 pg/mL). (B) Galectin-3 concentration in survivors and non-survivors. (C) Galectin-3 concentration in patients with (yes) and without (no) need in catecholamines. (D) Galectin-3 concentrations in patients with and without cardiac comorbidities. (E) Correlation analysis between galectin-3 and IL-6 plasma concentrations. (F) Correlation analysis between galectin-3 plasma concentration and the injury severity score (ISS). n = 107 patients, * p ≤ 0.05; *** p ≤ 0.001.

Figure 4

Cardiac risk factors and comorbidities in different groups of polytrauma patients. (A) Initial blood glucose concentration in the troponin subgroups (≤12 pg/mL; between 13–49 pg/mL and ≥50 pg/mL). (B) Initial triglyceride (TAG) blood concentrations in the troponin patients’ subgroups. (C) Body mass index (BMI) in the troponin subgroups. (D) Troponin T concentrations in patients with and without cardiac comorbidities. n = 107 patients, *** p ≤ 0.001 and **** p ≤ 0.0001.

Figure 5

Patients with cardiac comorbidities–subgroup analysis. Body Mass Index (BMI) (A) and initial blood glucose concentration (B) in patients with (yes) and without (no) cardiac comorbidities. (C) Troponin T concentration in the subgroup of patients with cardiac comorbidities depending on the need of catecholamines. (D) Patients with cardiac comorbidities: Troponin T concentration in survivors and non-survivors. (E) Correlation analysis between galectin-3 and the Injury Severity Score (ISS). Correlation analysis between galectin-3 and IL-6 (F) or the ventilation time (G). (H) Correlation analysis between troponin T concentration and the ventilation time. n = 24 patients, * p ≤ 0.05; ** p ≤ 0.01; *** p ≤ 0.001.