Update in the Management of Acute Coronary Syndrome Patients with Cardiogenic Shock

Bagai, Jayant; Brilakis, Emmanouil S.

doi:10.1007/s11886-019-1102-3

Cited by 9 publications

(4 citation statements)

References 42 publications

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“…Several prior studies using data from large RCTs and registries have identified individual factors that predispose CS (15,(20)(21)(22)(23). Concordantly, many of these factors, such as age, cardiovascular comorbidities, pre-existing cardiovascular disease, clinical and haemodynamic presentation, left ventricular systolic function and kidney function, were likewise found to be predictive of in-hospital CS in the present study.…”

Section: Discussionsupporting

confidence: 79%

A Risk Stratification Scheme for In-Hospital Cardiogenic Shock in Patients With Acute Myocardial Infarction

Yang

Ran

et al. 2022

Front. Cardiovasc. Med.

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ObjectiveCardiogenic shock (CS) is the leading cause of death in patients with acute myocardial infarction (AMI) despite advances in care. This study aims to derive and validate a risk score for in-hospital development of CS in patients with AMI.MethodsIn this study, we used the Improving Care for Cardiovascular Disease in China–Acute Coronary Syndrome (CCC–ACS) registry of 76,807 patients for model development and internal validation. These patients came from 158 tertiary hospitals and 82 secondary hospitals between 2014 and 2019, presenting AMI without CS upon admission. The eligible patients with AMI were randomly assigned to derivation (n = 53,790) and internal validation (n = 23,017) cohorts. Another cohort of 2,205 patients with AMI between 2014 and 2016 was used for external validation. Based on the identified predictors for in-hospital CS, a new point-based CS risk scheme, referred to as the CCC–ACS CS score, was developed and validated.ResultsA total of 866 (1.1%) and 39 (1.8%) patients subsequently developed in-hospital CS in the CCC–ACS project and external validation cohort, respectively. The CCC–ACS CS score consists of seven variables, including age, acute heart failure upon admission, systolic blood pressure upon admission, heart rate, initial serum creatine kinase-MB level, estimated glomerular filtration rate, and mechanical complications. The area under the curve for in-hospital development of CS was 0.73, 0.71, and 0.85 in the derivation, internal validation and external validation cohorts, respectively.ConclusionThis newly developed CCC–ACS CS score can quantify the risk of in-hospital CS for patients with AMI, which may help in clinical decision making.Clinical Trial Registrationwww.ClinicalTrials.gov, identifier: NCT02306616.

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Section: Discussionsupporting

confidence: 79%

A Risk Stratification Scheme for In-Hospital Cardiogenic Shock in Patients With Acute Myocardial Infarction

Yang

Ran

et al. 2022

Front. Cardiovasc. Med.

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“…[ 50 ] Some studies have summarized the management of cardiogenic shock complicated by ACS, which mainly includes early shock recognition, optimal selection and initiation of mechanical circulatory support, early coronary revascularization, shock team and implementation of standardized protocols, which play an important role in improving the outcome of cardiogenic shock in patients with ACS. [ 51 , 52 ] However, clinical practices for the management of cardiogenic shock are still inconsistent and knowledge gaps remain large, and it has become a future research trend to conduct systematic studies to explore the selection and timing of mechanical circulatory support and to standardize the medical care and management of patients with ACS complicated by cardiogenic shock.…”

Section: Discussionmentioning

confidence: 99%

The research progress and research trends in acute coronary syndrome nursing: A review of visual analysis based on the Web of Science database

Liu,

Li,

Mei

et al. 2024

Medicine

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Acute coronary syndrome (ACS) is one of the most common and severe forms of cardiovascular disease and has attracted worldwide attention with increased morbidity and mortality in recent years. There are few review studies in the field of its care in the form of bibliometric studies. We searched the Web of Science Core Collection database for articles and reviews in the area of ACS nursing for visual mapping analysis. Our objectives are to explore the hot topics and frontiers of research in the field of ACS nursing and to identify collaborative relationships between countries, institutions, and authors. This study will provide researchers with intuitive reference data for future in-depth studies of ACSs.

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“…These results indicate that invasive hemodynamic monitoring can be more beneficial for patients with CS caused by heart failure because it can be used to monitor hemodynamic profiles in real time and guide decision-making for optimal treatment to improve prognosis. Additionally, the prognosis of CS caused by ACS may be affected by revascularization procedures and interventional outcomes ( 33 ). Moreover, the study designs in the included articles may have partly explained the finding of an insignificant benefit of PAC in the management of CS caused by ACS.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of pulmonary artery catheter monitoring for patients with cardiogenic shock of various causes: a systematic review and meta-analysis

Lee¹,

Lee²,

Kim³

et al. 2023

J Thorac Dis

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Background: Cardiogenic shock is associated with significant morbidity and mortality. Invasive hemodynamic monitoring with pulmonary artery catheterization (PAC) can be useful in the assessment of changes in cardiac function and hemodynamic status; however, the benefits of PAC in the management of cardiogenic shock are not known well.Methods: We performed a systematic review and meta-analysis of observational studies and randomized controlled trials, comparing in-hospital mortality between PAC and non-PAC groups of cardiogenic shock patients with various underlying causes. Articles were obtained from MEDLINE, Embase, and Cochrane CENTRAL. We reviewed titles, abstracts, and full articles and evaluated the quality of evidence using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) framework. We used a random-effects model to compare studies in terms of in-hospital mortality findings. Results:We included twelve articles in our meta-analysis. Mortality among patients with cardiogenic shock was not significantly different between the PAC and the non-PAC groups [risk ratio (RR) 0.86, 95% confidence interval (CI): 0.73-1.02, I 2 =100%, P<0.01]. Two studies investigating cardiogenic shock caused by acute decompensated heart failure determined lower in-hospital mortality in the PAC group than in the non-PAC group (RR 0.49, 95% CI: 0.28-0.87, I 2 =45%, P=0.18). Six studies investigating cardiogenic shock of any cause determined lower in-hospital mortality in the PAC group than in the non-PAC group (RR 0.84, 95% CI: 0.72-0.97, I 2 =99%, P<0.01). There was no significant difference in in-hospital mortality between the PAC and non-PAC groups of patients with cardiogenic shock secondary to acute coronary syndrome (RR 1.01, 95% CI: 0.81-1.25, I 2 =99%, P<0.01).Conclusions: Overall, our meta-analysis demonstrated no significant association between PAC monitoring and in-hospital mortality among patients managed for cardiogenic shock. The use of PAC in the management of cardiogenic shock caused by acute decompensated heart failure was associated with lower inhospital mortality, but there was no association between PAC monitoring and in-hospital mortality among patients with cardiogenic shock caused by acute coronary syndrome.

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Update in the Management of Acute Coronary Syndrome Patients with Cardiogenic Shock

Cited by 9 publications

References 42 publications

A Risk Stratification Scheme for In-Hospital Cardiogenic Shock in Patients With Acute Myocardial Infarction

A Risk Stratification Scheme for In-Hospital Cardiogenic Shock in Patients With Acute Myocardial Infarction

The research progress and research trends in acute coronary syndrome nursing: A review of visual analysis based on the Web of Science database

Effectiveness of pulmonary artery catheter monitoring for patients with cardiogenic shock of various causes: a systematic review and meta-analysis

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