Outcome and Predictors for Mortality in Patients with Cardiogenic Shock: A Dutch Nationwide Registry-Based Study of 75,407 Patients with Acute Coronary Syndrome Treated by PCI

Mina Karami, Elma J. Peters, Wim K. Lagrand, Saskia Houterman, Corstiaan A. den Uil, Annemarie E. Engstrom, Luuk C. Otterspoor, Jan Paul Ottevanger, Irlando A. Ferreira, Jose M. Montero-Cabezas, Krischan Sjauw, Jan van Ramshorst, Adriaan O. Kraaijeveld, Niels J. W. Verouden, Erik Lipsic, Alexander P. Vlaar, Jose P. S. Henriques*

*Corresponding author for this work

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    Abstract

    It is important to gain more insight into the cardiogenic shock (CS) population, as currently, little is known on how to improve outcomes. Therefore, we assessed clinical outcome in acute coronary syndrome (ACS) patients treated by percutaneous coronary intervention (PCI) with and without CS at admission. Furthermore, the incidence of CS and predictors for mortality in CS patients were evaluated. The Netherlands Heart Registration (NHR) is a nationwide registry on all cardiac interventions. We used NHR data of ACS patients treated with PCI between 2015 and 2019. Among 75,407 ACS patients treated with PCI, 3028 patients (4.1%) were identified with CS, respectively 4.3%, 3.9%, 3.5%, and 4.3% per year. Factors associated with mortality in CS were age (HR 1.02, 95%CI 1.02-1.03), eGFR (HR 0.98, 95%CI 0.98-0.99), diabetes mellitus (DM) (HR 1.25, 95%CI 1.08-1.45), multivessel disease (HR 1.22, 95%CI 1.06-1.39), prior myocardial infarction (MI) (HR 1.24, 95%CI 1.06-1.45), and out-of-hospital cardiac arrest (OHCA) (HR 1.71, 95%CI 1.50-1.94). In conclusion, in this Dutch nationwide registry-based study of ACS patients treated by PCI, the incidence of CS was 4.1% over the 4-year study period. Predictors for mortality in CS were higher age, renal insufficiency, presence of DM, multivessel disease, prior MI, and OHCA.

    Original languageEnglish
    Article number2047
    Number of pages10
    JournalJournal of Clinical Medicine
    Volume10
    Issue number10
    DOIs
    Publication statusPublished - 11-May-2021

    Keywords

    • cardiogenic shock
    • percutaneous coronary intervention
    • acute coronary syndrome
    • clinical outcome
    • predictors
    • MYOCARDIAL-INFARCTION
    • TERM MORTALITY
    • ST-ELEVATION

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