Key result
Cardiogenic shock from severe VHD is linked to ~32% higher in-hospital mortality versus no severe VHD.
Why the study?
Cardiogenic shock can be complicated by severe valvular heart disease, prompting an analysis of cardiac intensive care unit admissions by VHD status.
Does the presence and causative nature of severe valvular heart disease impact in-hospital mortality in patients with cardiogenic shock?
Observational (n=5,242)
Yes
Does the presence and causative nature of severe valvular heart disease impact in-hospital mortality in patients with cardiogenic shock?
Severe valvular heart disease is the underlying cause in a minority (4.1%) of cardiogenic shock admissions but is associated with a high in-hospital mortality rate of 40.0%.
BACKGROUND: Cardiogenic shock (CS) can be complicated by severe valvular heart disease (VHD). We analyzed cardiac intensive care unit (CICU) admissions according to VHD status. METHODS AND RESULTS: The Critical Care Cardiology Trials Network is a multicenter network of tertiary CICUs. Centers contributed data from consecutive admissions during 2-month annual snapshots from 2017-2023. CS admissions were classified as having CS attributed to VHD, CS with noncausative VHD or CS without severe VHD. Demographics and therapies were compared. Unadjusted and adjusted odds ratios for in-hospital mortality were calculated. We analyzed 5242 admissions with CS (4.1% attributed to VHD, 18.8% with noncausative VHD, 77.1% without severe VHD). Mitral regurgitation (32.1%) and aortic stenosis (27.9%) were the most common pathologies in CS attributed to VHD. Admissions with CS attributed to VHD more commonly had LVEF ≥ 40% on admission (present in 62.8%, 22.6% and 15.1%, respectively; P < 0.001). Valve intervention was performed in 32.1% of those with CS attributed to VHD. Unadjusted in-hospital mortality in admissions with CS attributed to VHD was 40.0%, compared to 33.4% and 30.3% in the other groups. CONCLUSIONS: VHD is the underlying cause of CS in a minority of CICU admissions but is associated with high in-hospital mortality rates.
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Carnicelli et al. (2025) conducted an observational in Cardiogenic shock and valvular heart disease (n=5,242). Cardiogenic shock attributed to severe valvular heart disease vs. Cardiogenic shock with noncausative VHD or without severe VHD was evaluated on In-hospital mortality. Cardiogenic shock attributed to severe valvular heart disease was associated with an unadjusted in-hospital mortality of 40.0%, compared to 33.4% and 30.3% in those with noncausative or no severe VHD.
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