Eligibility for mechanical circulatory support devices based on current and past randomised cardiogenic shock trials

Schrage, Benedikt; Beer, Benedikt N; Savarese, Gianluigi; Dabboura, Salim; Yan, Isabell; Sundermeyer, Jonas; Becher, Peter Moritz; Grahn, Hanno; Seiffert, Moritz; Bernhardt, A.; Thiele, Holger; Møller, Jacob Eifer; Kluge, Stefan; Reichenspurner, Hermann; Kirchhof, Paulus; Blankenberg, Stefan; Westermann, Dirk

doi:10.1002/ejhf.2274

Cited by 30 publications

(30 citation statements)

References 22 publications

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“…Only one third of this real‐world population with CS was eligible for any trial. This was mostly due to the exclusion of CS not secondary to acute myocardial infarction (AMI), but even in a post‐AMI CS scenario only 65.4% of patients were eligible 28 …”

Section: Cardiogenic Shockmentioning

confidence: 99%

“…26 However, data from randomized controlled trials (RCTs) seem not to reflect real-world practice. Schrage et al 28 applied enrolment criteria from the main RCTs about MCS use in CS to 1305 patients with CS admitted to a tertiary care hospital between 2009 and 2019. Only one third of this real-world population with CS was eligible for any trial.…”

Section: Cardiogenic Shockmentioning

confidence: 99%

“…This was mostly due to the exclusion of CS not secondary to acute myocardial infarction (AMI), but even in a post-AMI CS scenario only 65.4% of patients were eligible. 28…”

Section: Cardiogenic Shockmentioning

confidence: 99%

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November 2021 at a glance: focus on prevention, comorbidities, cardiogenic shock and novel devices

Tomasoni

Adamo

Metra

2021

European J of Heart Fail

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Imaging and heart failure preventionThe role of imaging in the management of heart failure (HF) is well established. [1][2][3] Less evidence is available regarding its role in HF prevention. The Copenhagen City Heart Study investigated the prognostic value of whole wall, endomyocardial, and epimyocardial global longitudinal strain (GLS) in the general population. In the sex-stratified analysis, whole wall and epimyocardial GLS were found to be significant predictors of prognosis in males, while no GLS parameter was useful in females. 4 Another study investigated the presence of subclinical congestion, assessed by three ultrasound (US) variables (inferior vena cava diameter, jugular vein distensibility ratio, the number of B-lines from a 28-point lung US), in patients with at least one risk factor for HF, including diabetes, ischaemic heart disease, and hypertension. Subclinical congestion was common and was described in 30% of subjects. Plasma natriuretic peptide concentrations were more closely related to left atrial volume than other US measures of congestion. 5

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Section: Cardiogenic Shockmentioning

confidence: 99%

Section: Cardiogenic Shockmentioning

confidence: 99%

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November 2021 at a glance: focus on prevention, comorbidities, cardiogenic shock and novel devices

Tomasoni

Adamo

Metra

2021

European J of Heart Fail

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“…Schrage and colleagues illustrate that the major trials of CS are fundamentally challenged by selecting a narrow subset of ACS CS, while the remainder of unstudied patients have a similar and devastatingly high mortality rate. 19 The way forward is to conduct trials involving an 'all-comers' population, and stratify by severity of shock (perhaps by prospectively assigning Society for Cardiac Angiography and Intervention Shock Stage, SCAI). 21 The other key variable is the presence of cardiac arrest, as many patients die of neurological injury and not cardiac dysfunction.…”

mentioning

confidence: 99%

“…But will these trials guide clinicians in the care of the patients seen in common practice? This is the hypothesis that Schrage and colleagues address in this issue of the Journal 19 . The authors take the inclusion and exclusion criteria for the three trials mentioned as well as the IABP‐SHOCK II trial and apply these to a 1305 patient contemporary CS registry at a single tertiary medical centre, involving consecutive cases from 2009–2019 20 .…”

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confidence: 99%

A deceptively simple problem: the case of cardiogenic shock

Baran

2021

European J of Heart Fail

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Heart failure: an update from the last years and a look at the near future

et al. 2022

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In the last years, major progress occurred in heart failure (HF) management. Quadruple therapy is now mandatory for all the patients with HF with reduced ejection fraction. Whilst verciguat is becoming available across several countries, omecamtiv mecarbil is waiting to be released for clinical use. Concurrent use of potassium-lowering agents may counteract hyperkalaemia and facilitate renin-angiotensin-aldosterone system inhibitor implementations. The results of the EMPagliflozin outcomE tRial in Patients With chrOnic heaRt Failure With Preserved Ejection Fraction (EMPEROR-Preserved) trial were confirmed by the Dapagliflozin in Heart Failure with Mildly Reduced or Preserved Ejection Fraction (DELIVER) trial, and we now have, for the first time, evidence for treatment of also patients with HF with preserved ejection fraction. In a pre-specified meta-analysis of major randomized controlled trials, sodium-glucose co-transporter-2 inhibitors reduced all-cause mortality, cardiovascular (CV) mortality, and HF hospitalization in the patients with HF regardless of left ventricular ejection fraction. Other steps forward have occurred in the treatment of decompensated HF. Acetazolamide in Acute Decompensated Heart Failure with Volume Overload (ADVOR) trial showed that the addition of intravenous acetazolamide to loop diuretics leads to greater decongestion vs. placebo. The addition of hydrochlorothiazide to loop diuretics was evaluated in the CLOROTIC trial. Torasemide did not change outcomes, compared with furosemide, in TRANSFORM-HF. Ferric derisomaltose had an effect on the primary outcome of CV mortality or HF rehospitalizations in IRONMAN (rate ratio 0.82; 95% confidence interval 0.66-1.02; P = 0.070). Further options for the treatment of HF, including device therapies, cardiac contractility modulation, and percutaneous treatment of valvulopathies, are summarized in this article.

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Eligibility for mechanical circulatory support devices based on current and past randomised cardiogenic shock trials

Cited by 30 publications

References 22 publications

November 2021 at a glance: focus on prevention, comorbidities, cardiogenic shock and novel devices

November 2021 at a glance: focus on prevention, comorbidities, cardiogenic shock and novel devices

A deceptively simple problem: the case of cardiogenic shock

Heart failure: an update from the last years and a look at the near future

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