Tendencias en el tratamiento del shock cardiogénico e impacto pronóstico del tipo de centros tratantes

Sánchez‐Salado, José Carlos; Burgos, Virginia; Arizá-Solé, Albert; Sionís, Alessandro; Canteli, A.; Bernal, José Luís; Fernández, Cristina; Castrillo, Cristina; Ruíz-Lera, Marta; López-de-Sá, Esteban; Lidón, Rosa María; Worner, Fernando; Martínez‐Sellés, Manuel; Segovia, Javier; Viana-Tejedor, Ana; Lorente, Victòria; Alegre, Oriol; Llaó, Isaac; González‐Costello, José; Manito, Nicolás; Cequier, Ángel; Bueno, Héctor; Elola, Javier

doi:10.1016/j.recesp.2019.10.009

Cited by 33 publications

(4 citation statements)

References 24 publications

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“…However they included patients with different profile, with only a 12% of ACS patients and 26% of patients being admitted to a non-university hospital. The admission in a tertiary hospital with specialized ICCU has been shown as an independent predictor of lower in-hospital mortality in a recent STEMI CS Spanish registry (22) and the allocation of patients to such centers has been widely recommended (23). In- hospital mortality in the ECMO-CS study was 50% (18), also higher than in our registry, although this trial only included ECMO candidates with refractory CS, limiting direct comparison with other CS registries.…”

Section: Discussionmentioning

confidence: 99%

Cardiogenic Shock Mortality According to Aetiology in a Mediterranean Cohort: Results From the Shock-Cat Study

García-García,

López-Sobrino,

Sanz-Girgas

et al. 2024

Preprint

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Background and objectivesMortality in cardiogenic shock (CS) remains elevated, with the potential for CS causes to impact prognosis and risk stratification. The aim was to investigate in-hospital prognosis and mortality in CS patients according to aetiology. We also assessed the prognostic accuracy of CardShock and IABP-SHOCK II scores.MethodsShock-CAT study was a multicentre, prospective, observational study conducted from December 2018-November 2019 in eight University hospitals in Catalonia, including non-selected consecutive CS patients. Data on clinical presentation, management, including mechanical circulatory support (MCS) were analysed comparing acute myocardial infarction (AMI) related CS and non-AMI-CS. The accuracy of CardShock and IABP-SHOCK II scores to assess 90-days mortality risk were also compared.ResultsA total of 382 CS patients were included, age 65.3 (SD 13.9) years, 75.1% men. Patients were classified as AMI-CS (n=232, 60.7%) and non-AMI-CS (n=150, 39.3%). In the AMI-CS group, 77.6% were STEMI. Main aetiologies for non-AMI-CS were heart failure (36.2%), arrhythmias (22.1%) and valve disease (8.0%). AMI-CS patients required more MCS than non-AMI-CS (43.1% vs 16.7%, p<0.001). In-hospital mortality was higher in AMI-CS (37.1 vs 26.7%, p=0.035), with a two-fold increased risk after multivariate adjustment (OR 2.24, p=0.019). The IABP-SHOCK II had superior discrimination for predicting 90-days mortality when compared with CardShock in AMI-CS patients (AUC 0.74 vs 0.66, p=0.047) although both scores performed similarly in non-AMI-CS (AUC 0.64 vs 0.62, p=0.693).ConclusionsIn our cohort, AMI-CS mortality was increased by two-fold when compared to non- AMI-CS. IABP-SHOCK II score provides better 90-days mortality risk prediction than CardShock score in AMI-CS, but both scores performed similar in non-AMI-CS patients.

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Section: Discussionmentioning

confidence: 99%

Cardiogenic Shock Mortality According to Aetiology in a Mediterranean Cohort: Results From the Shock-Cat Study

García-García,

López-Sobrino,

Sanz-Girgas

et al. 2024

Preprint

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“…This value is higher than those reported in the French registry (63%) in 2005 [5] and similar to those from the Italian study (83%) [10] in 2014. Both coronary revascularization procedures and the availability of an intensive cardiac care unit have been associated with lower mortality rates [8], although benefits in survival with the use of hemodynamic support devices (i.e., an intra-aortic balloon pump [11] or Impella support [20,21]) are as yet inconclusive. Furthermore, despite proper reperfusion, no differences in mechanical complications or ventricular arrhythmias were observed over the last 30 years.…”

Section: Stemi-cs 30-day and 1-year Mortality Trendsmentioning

confidence: 99%

“…Data on long-term trends in STEMI-CS prevalence and short-and long-term mortality are scarce. Indeed, most of the reported data reflect either limited trends, rarely beyond a decade, or only in-hospital or short-term evolution [8,9]. Accordingly, the aim of this study was to describe trends in prevalence, management, in-hospital complications, and 30-day and 1-year mortality in STEMI-CS over the last three decades .…”

Section: Introductionmentioning

confidence: 99%

“…CS is the leading cause of hospital mortality associated with acute myocardial infarction (MI). Prevalence of CS due to acute MI varies from 5 to 15% [1][2][3][4][5][6][7][8], although some of these data come from studies performed before the generalization of reperfusion [1,2]. Despite recent advances in the prevention and management of acute MI, and the widespread use of primary percutaneous coronary intervention in patients with ST-elevation MI (STEMI), acute phase mortality of STEMI-complicated CS (STEMI-CS) remains unacceptably high [6][7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

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Short- and Long-Term Mortality Trends in STEMI-Cardiogenic Shock over Three Decades (1989–2018): The Ruti-STEMI-Shock Registry

García-García

Oliveras

Ouaddi

et al. 2020

JCM

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Aims: Cardiogenic shock (CS) is an ominous complication of ST-elevation myocardial infarction (STEMI), despite the recent widespread use of reperfusion and invasive management. The Ruti-STEMI-Shock registry analysed the prevalence of and 30-day and 1-year mortality rates in ST-elevation myocardial infarction (STEMI) complicated by CS (STEMI-CS) over the last three decades. Methods and Results: From February 1989 to December 2018, 493 STEMI-CS patients were consecutively admitted in a well-defined geographical area of ~850,000 inhabitants. Patients were classified into six five-year periods based on their year of admission. STEMI-CS mortality trends were analysed at 30 days and 1 year across the six strata. Cox regression analyses were performed for comparisons. Mean age was 67.5 ± 11.7 years; 69.4% were men. STEMI-CS prevalence did not decline from period 1 to 6 (7.1 vs. 6.2%, p = 0.218). Reperfusion therapy increased from 22.5% in 1989–1993 to 85.4% in 2014–2018. Thirty-day all-cause mortality declined from period 1 to 6 (65% vs. 50.5%, p < 0.001), with a 9% reduction after multivariable adjustment (HR: 0.91; 95% CI: 0.84–0.99; p = 0.024). One-year all-cause mortality declined from period 1 to 6 (67.5% vs. 57.3%, p = 0.001), with an 8% reduction after multivariable adjustment (HR: 0.92; 95% CI: 0.85–0.99; p = 0.030). Short- and long-term mortality trends in patients aged ≥ 75 years remained ~75%. Conclusions: Short- and long-term STEMI-CS-related mortality declined over the last 30 years, to ~50% of all patients. We have failed to achieve any mortality benefit in STEMI-CS patients over 75 years of age.

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Pulmonary Artery Catheter Use and Outcomes in Patients With ST-Elevation Myocardial Infarction and Cardiogenic Shock Treated With Impella (a Nationwide Analysis from the United States)

Ismayl

Hussain

Aboeata

et al. 2023

The American Journal of Cardiology

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Tendencias en el tratamiento del shock cardiogénico e impacto pronóstico del tipo de centros tratantes

Cited by 33 publications

References 24 publications

Cardiogenic Shock Mortality According to Aetiology in a Mediterranean Cohort: Results From the Shock-Cat Study

Cardiogenic Shock Mortality According to Aetiology in a Mediterranean Cohort: Results From the Shock-Cat Study

Short- and Long-Term Mortality Trends in STEMI-Cardiogenic Shock over Three Decades (1989–2018): The Ruti-STEMI-Shock Registry

Pulmonary Artery Catheter Use and Outcomes in Patients With ST-Elevation Myocardial Infarction and Cardiogenic Shock Treated With Impella (a Nationwide Analysis from the United States)

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