Simon Kraler: Can the Adrenomedullin System Predict Cardiogenic Shock Before It Happens?
Simon Kraler, ESC Young Cardiovascular Professionals Committee Member at European Society of Cardiology, Cardiology Resident at University Hospital Zurich, shared a post on LinkedIn about a recent article he and his colleagues co-authored, published in European Heart Journal, adding:
”The RAAS regulates vascular tone, the adrenomedullin (ADM) system regulates vascular leakage
Can it tell us which patient is about to develop infarct-related cardiogenic shock?
Very excited to share our new work, published today in the European Heart Journal, with simultaneous presentation at ESC Congress 2026.
Cardiogenic shock remains the most devastating complication of acute coronary syndromes, with incredibly high mortality.
Loss of vascular integrity, inflammation, capillary leakage, and vasodilatation may begin well before overt shock becomes clinically apparent.
We therefore investigated the adrenomedullin (ADM) system – ADM-Gly, its activating enzyme PAM, and biologically active ADM – in two independent ACS cohorts from Switzerland and France.
What did we find?
ADM-Gly and bio-ADM link to inflammation and haemodynamic compromise and independently predict the development of cardiogenic shock and 1-year mortality in initially stable patients with ACS
Incorporating these biomarkers into the ORBI and SEX-SHOCK scores improved early identification of patients at risk, with consistent findings in external validation.
The ADM system may provide a window into early endothelial dysfunction and vascular leakage before overt haemodynamic compromise ensues – and potentially help us identify the vulnerable patient while there is still time to intervene.
Congratulations to Yifan Wang and the entire SPUM-ACS and FAST-MI team for this truly collaborative effort across Switzerland, Germany, and France and many thanks to Thomas F. Lüscher and Giovanni G Camici, for all their support throughout this project.”
Title: Adrenomedullin system dysregulation predicts cardiogenic shock and mortality in acute coronary syndromes
Authors: Yifan Wang, Nicolas Danchin, Tabassome Simon, Marianne Zeller, Yulia Ilina, Paul Kaufmann, Andreas Bergmann, Florian A Wenzl, Victor Schweiger, Luca Liberale, Lorenz Räber, Christian Templin, Arnold von Eckardstein, Marco Roffi, Olivier Muller, Jeronim Berisha, Giovanni G Camici, Laurence Bérard, Birte Arlt, David Niederseer, Thomas F Lüscher, Simon Kraler
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