Cardiogenic shock mortality according to Aetiology in a Mediterranean cohort : Results from the Shock-CAT study
Garcia Garcia, Cosme (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
López-Sobrino, Teresa (Institut d'Investigacions Biomèdiques August Pi i Sunyer)
Sanz-Girgas, Esther (Hospital Universitari Joan XXIII de Tarragona)
Ruiz Cueto, María (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Aboal, Jaime (Hospital Universitari de Girona Doctor Josep Trueta)
Pastor, Pablo (Hospital Universitari Arnau de Vilanova (Lleida))
Buera Surribas, Irene (Hospital Universitari Vall d'Hebron)
Sionis, Alessandro (Institut de Recerca Sant Pau)
Andrea-Riba, Rut (Hospital Clínic i Provincial de Barcelona)
Rodríguez-López, Judit (Hospital Universitari Joan XXIII de Tarragona)
Sánchez-Salado, Jose Carlos (Hospital Universitari de Bellvitge)
Tomas, Carlos (Hospital Universitari Arnau de Vilanova (Lleida))
Bañeras, Jordi (Hospital Universitari Vall d'Hebron)
Ariza-Solé, Albert (Hospital Universitari de Bellvitge)
Lupón, Josep (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Bayés-Genís, Antoni (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Rueda, Ferran (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Universitat Autònoma de Barcelona

Data:	2024
Resum:	Aims: Mortality 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. Methods: Shock-CAT study was a multicentre, prospective, observational study conducted from December 2018 to 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 day mortality risk were also compared. Results: A 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 (odds ratio 2. 24, P = 0. 019). The IABP-SHOCK II had superior discrimination for predicting 90 day mortality when compared with CardShock in AMI-CS patients [area under the curve (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). Conclusions: In our cohort, AMI-CS mortality was increased by two-fold when compared with non-AMI-CS. IABP-SHOCK II score provides better 90 day mortality risk prediction than CardShock score in AMI-CS, but both scores performed similar in non-AMI-CS patients.
Nota:	Altres ajuts: acords transformatius de la UAB
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Cardiogenic shock ; Myocardial infarction ; Mortality ; Prognosis ; Risk score
Publicat a:	ESC Heart Failure, 2024 , ISSN 2055-5822

DOI: 10.1002/ehf2.15148
PMID: 39587711

10 p, 634.0 KB

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Documents de recerca > Documents dels grups de recerca de la UAB > Centres i grups de recerca (producció científica) > Ciències de la salut i biociències > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
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