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. 2021 May 11;10(10):2047.
doi: 10.3390/jcm10102047.

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  1 , Elma J Peters  1 , Wim K Lagrand  2 , Saskia Houterman  3 , Corstiaan A den Uil  4   5   6 , Annemarie E Engström  6 , Luuk C Otterspoor  7 , Jan Paul Ottevanger  8 , Irlando A Ferreira  8 , Jose M Montero-Cabezas  9 , Krischan Sjauw  10 , Jan van Ramshorst  11 , Adriaan O Kraaijeveld  12 , Niels J W Verouden  13 , Erik Lipsic  14 , Alexander P Vlaar  2 , Jose P S Henriques  1 , On Behalf Of The Pci Registration Committee Of The Netherlands Heart Registration
Affiliations

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 et al. J Clin Med. .

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.

Keywords: acute coronary syndrome; cardiogenic shock; clinical outcome; percutaneous coronary intervention; predictors.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of study population: acute coronary syndrome patients treated by percutaneous coronary intervention with (n = 3028) and without cardiogenic shock (n = 72,379).
Figure 2
Figure 2
Kaplan–Meier curves showing survival of acute coronary syndrome patients treated by percutaneous coronary intervention with and without cardiogenic shock at admission. (a) Over the 4-year study period, (b) within 30-days.
See this image and copyright information in PMC

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