Very high levels of PSA in patients with cardiogenic shock: Report of four clinical cases

• Published in: Clinical biochemistry 2020-02, Vol.76, p.42-44
• Main Authors: Fernández-Galán, Esther, Augé, Josep M., Molina, Rafael, Filella, Xavier
• Format: Article
• Language: English
• Subjects: Cardiogenic shock; Humans; Middle Aged; Prostate cancer; Prostate Cancer Screening; Prostate specific antigen; Prostate-Specific Antigen - blood; PSA; Retrospective Studies; Shock, Cardiogenic - blood
• ISSN: 0009-9120; 1873-2933
• DOI: 10.1016/j.clinbiochem.2019.11.002

•Prostatic ischemia and cellular damage can occur during cardiogenic shock.•Increased PSA serum levels during cardiogenic shock might be associated with prostatic cellular damage.•Cardiogenic shock is a cause of PSA false positive results.•High PSA concentrations in patients with cardiogenic shock cannot be considered as a marker of PCa. Prostate-specific antigen (PSA) is the tumor marker most widely used in conjunction with digital rectal examination (DRE) for the early detection of prostate cancer (PCa). Due to its limitations, especially the high rate of false positive (FP) results, PSA screening of transplant candidates is a controversial issue. Moreover, obtaining a FP result in the PCa screening of heart transplant candidates may lead to potentially harmful effects. Although most of the factors that may cause PSA FP results are well known, FP results related to cardiogenic shock, a common indication for heart transplant, are less known. We studied retrospectively four patients who suffered cardiogenic shock during their hospital stay and became heart transplant candidates. Their PSA serum levels were very high suggesting the presence of PCa. Our findings have shown that elevated PSA serum levels in these patients were not related to PCa and they might be associated with cardiogenic shock. This clinical case study adds evidences to the fact that cardiogenic shock is an important cause of PSA FP results, therefore it cannot be used as a reliable marker of PCa in this clinical condition and positive results should be properly interpreted.