Key result
ACS with cardiogenic shock carries ~61% in-hospital mortality despite frequent revascularization.
Why the study?
Cardiogenic shock is a life-threatening complication of AMI and a leading cause of death, prompting an investigation of clinical characteristics, treatment strategies, hospital outcomes, and 30-day mortality in Argentina.
Observational (n=114)
Yes
Morbidity and mortality of cardiogenic shock complicating ACS remain extremely high (over 60% at 30 days) despite high rates of reperfusion therapy.
Mortality remains high in ACS cardiogenic shock despite revascularization; leaves open the need for adjunctive strategies in prospective studies.
Background: Cardiogenic shock (CS) is a life-threatening complication of acute myocardial infarction (AMI) and constitutes one of the leading causes of death. Objective: The aim of this study was to investigate the clinical characteristics, treatment strategies, hospital outcome and 30-day mortality of CS in Argentina. Methods: We conducted a prospective, and multicenter registry of patients with acute coronary syndromes (ACS) with and without ST-segment elevation complicated with CS that were hospitalized in 23 centers in Argentina for 14 months (between August 1, 2021, and September 30, 2022). Results: The cohort was made up of 114 patients; median age was 64 years (58-73) and 72% were women; 76.3% corresponded to ST-segment elevation ACS, 12.3% to non-ST-segment elevation ACS, 7% had right ventricular infarction and 4.4% had mechanical complications. In 66.6% of cases CS was present on admission. Revascularization: 91.1%, use of inotropic agents: 98.2%, mechanical ventilation (MV): 59.6%, Swan-Ganz catheter: 33.3%, intra-aortic balloon pump: 30.1%. Overall in-hospital mortality was 60.5%, with no differences between ACS with or without ST-segment elevation, and was 62.6% at 30 days. Conclusion: Morbidity and mortality of CS are high despite the high rate of reperfusion therapy used.
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Costa et al. (2023) conducted an observational in Cardiogenic shock in the setting of acute coronary syndromes (n=114). Cardiogenic shock in the setting of acute coronary syndromes was evaluated on In-hospital mortality. In patients with acute coronary syndromes complicated by cardiogenic shock in Argentina, overall in-hospital mortality was 60.5% and 30-day mortality was 62.6% despite a 91.1% revascularization rate.
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