Cardiogenic Shock in the Setting of Acute Coronary Syndrome: Predictive Factors and Outcomes in a Moroccan population

Introduction: Cardiogenic shock (CS) is a life-threatening complication in patients with acute coronary syndrome (ACS), and its development can be unpredictable. The aim of this study was to find independent predictive factors of CS in a Moroccan cohort of ACS patients. Methods: This was a retrospective, comparative, and analytical monocentric study, including 319 ACS patients admitted between January 2018 to April 2021 in MVMIH’s cardiology center. Patients who presented with CS on admission were excluded from the study. This population was divided into two groups: the « shock » group patients eventually developed in-hospital CS and the « no shock » group which did not, and we compared overall patient characteristics and outcomes. Results: 319 ACS patients were included, among them 21 (6,6%) developed CS. Overall, the strongest predictive factors included the presence of acute heart failure on admission (OR = 14,83; 95% CI = 5,45 – 40,32; p < 0,001), GRACE score ≥ 140 (OR = 9,03; 95% CI = 3,20 – 25,46; p < 0,001), left ventricular ejection fraction < 50% (OR = 8,94; 95% CI = 3,08 – 19,53; p < 0,001), eccentric left ventricular hypertrophy (OR = 9,78; 95% CI = 2,61 – 36,70; p < 0,001), and right ventricular dysfunction (OR = 12,25; 95% CI = 2,55 – 58,93; p = 0,002). Complications were more prevalent in the « shock » group with a higher mortality rate of 57,1%. Conclusion: CS in the setting of ACS is correlated with poorer prognosis and higher late mortality, justifying adequate and early diagnosis and management in high-risk patients.