Catalan Society of Cardiology Grant to Support the Search for New Biomarkers of Cardiogenic Shock

The Catalan Society of Cardiology has awarded one of its 2026 Society Grants to a Sant Pau project that will study the potential of circulating microRNAs to characterize patients with cardiogenic shock more accurately and improve predictions of their clinical course. The €10,000 grant will support the first phase of the research.

The project, titled “Molecular Characterization of Cardiogenic Shock Using Plasma MicroRNAs: Identification of Differential Signatures for Subphenotyping and Prognosis,” is co-led by Dr. Alessandro Sionis, a cardiologist at Hospital de Sant Pau and a researcher with the Clinical and Translational Cardiology group at the Sant Pau Research Institute (IR Sant Pau), and Dr. Teresa Padró, head of the Cardiovascular Disease Biomarkers group. Carlos González, a doctoral student, is also involved in the project, which will additionally include Dr. Montserrat Vila, Dr. Laura Rodríguez, Dr. Lluís Asmarats, and Dr. Mireia Padilla, all cardiologists at Hospital de Sant Pau and researchers with the Clinical and Translational Cardiology group.

An Extremely Severe and Highly Heterogeneous Condition

Cardiogenic shock is an extremely severe clinical condition that occurs when the heart is unable to maintain sufficient blood flow to ensure adequate perfusion of tissues and organs. Although advances in coronary revascularization and circulatory support devices have improved its management, it continues to be associated with high morbidity and mortality, with an estimated 40% to 50% mortality rate during the first year.

This complication can occur mainly as a consequence of an acute myocardial infarction or in the context of heart failure. However, even within these groups, there are significant differences in the biological mechanisms involved, the body’s response, the extent of damage to other organs, and the clinical course.

This considerable heterogeneity is one of the main challenges in managing the condition. Classifications based solely on the cause, severity, or hemodynamic parameters do not always make it possible to predict each patient’s clinical course with sufficient accuracy. Cardiovascular research is therefore working to identify subphenotypes based on biological characteristics that could support a more personalized approach.

“Cardiogenic shock remains one of the most serious situations we face in cardiology. Clinical outcomes can differ greatly among patients who initially present with a similar clinical picture, and having new biomarkers available could help us better anticipate this risk and guide decision-making,” explains Dr. Alessandro Sionis.

Molecular Profiles to Better Characterize Patients

The project will study microRNAs present in plasma, small RNA molecules that regulate gene expression and can act as biomarkers of different biological processes. The researchers hypothesize that patients with cardiogenic shock associated with myocardial infarction and those who develop it in the context of heart failure have specific plasma microRNA profiles.

“MicroRNAs can be detected stably in plasma and can reflect processes such as inflammation, damage to the heart muscle, or dysfunction in other organs, all of which play an important role in the progression of cardiogenic shock. Studying them may help us better understand what is happening in each patient beyond what we can observe through routine clinical assessment,” says Dr. Padró.

Identifying these signatures would make it possible to define patient subgroups based on their molecular characteristics, beyond the origin and initial severity of the condition. The team will analyze whether these profiles can improve risk stratification and the prediction of short- and long-term outcomes. It will also compare their discriminatory ability with that of the clinical scores and other biomarkers currently used.

An Initial Phase Involving 30 Patients

In the initial stage, the team will analyze plasma samples from 30 patients: 15 with cardiogenic shock associated with acute myocardial infarction and 15 with cardiogenic shock related to heart failure. High-throughput analysis techniques will be used to study the full set of circulating microRNAs, followed by bioinformatics tools to select the 20 candidates with the greatest potential as biomarkers.

In subsequent phases, the selected microRNAs will be validated using real-time quantitative PCR. The profiles of the two groups of patients with cardiogenic shock will be compared with each other and with control groups consisting of people with myocardial infarction or heart failure who have not developed this complication.

The grant will specifically fund the first phase of the project, which is expected to last 12 months. This phase will include patient selection, sample collection and analysis, identification of differential microRNA profiles, and bioinformatics studies. Should this stage be completed ahead of schedule, the team will proceed with validating the selected biomarkers.

A Long-Standing Collaboration Between Clinical Care and Research

The project is based on more than 15 years of collaboration between the clinical teams at Hospital de Sant Pau and the Clinical and Translational Cardiology and Cardiovascular Disease Biomarkers groups at IR Sant Pau. Throughout this period, they have worked together to identify and study molecular and epigenetic biomarkers that could help improve the diagnosis, risk stratification, and clinical management of cardiovascular diseases.

The research also builds on previous findings linking different microRNAs to the risk and prognosis of cardiogenic shock. These include miR-619-5p, elevated concentrations of which have been associated with a higher risk of developing this complication in patients with acute myocardial infarction, as well as with processes related to the inflammatory response.

The Acute Cardiac Care Unit at Hospital de Sant Pau treats approximately 70 patients with cardiogenic shock each year and has access to advanced mechanical circulatory support devices and a heart transplant program. This clinical experience, combined with IR Sant Pau’s expertise in omics technologies, molecular analysis, and bioinformatics, provides the necessary environment for the project’s development.

“Our accumulated experience in caring for these patients enables us to formulate research questions that are directly connected to the problems we encounter in clinical practice. At the same time, IR Sant Pau’s capabilities make it possible to address these questions from a molecular perspective and move toward new tools that may ultimately benefit patients,” concludes Dr. Sionis.