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Observational Study
. 2025 Apr;12(2):1336-1345.
doi: 10.1002/ehf2.15148. Epub 2024 Nov 25.

Cardiogenic shock mortality according to Aetiology in a Mediterranean cohort: Results from the Shock-CAT study

Cosme García-García  1   2   3 , Teresa López-Sobrino  4   5 , Esther Sanz-Girgas  6 , Maria R Cueto  2   7 , Jaime Aboal  8 , Pablo Pastor  9 , Irene Buera  10 , Alessandro Sionis  1   3   11 , Rut Andrea  4 , Judit Rodríguez-López  6 , Jose Carlos Sánchez-Salado  7 , Carlos Tomas  9 , Jordi Bañeras  10 , Albert Ariza  7 , Josep Lupón  1   2   3 , Antoni Bayés-Genís  1   2   3 , Ferran Rueda  2 ; Grup de Treball de Cures Agudes Cardiològiques Societat Catalana de Cardiologia
Affiliations
Observational Study

Cardiogenic shock mortality according to Aetiology in a Mediterranean cohort: Results from the Shock-CAT study

Cosme García-García et al. ESC Heart Fail. 2025 Apr.

Abstract

Aims: Mortality in cardiogenic shock (CS) remains elevated, with the potential for CS causes to impact prognosis and risk stratification. The aim was to investigate in-hospital prognosis and mortality in CS patients according to aetiology. We also assessed the prognostic accuracy of CardShock and IABP-SHOCK II scores.

Methods: Shock-CAT study was a multicentre, prospective, observational study conducted from December 2018 to November 2019 in eight university hospitals in Catalonia, including non-selected consecutive CS patients. Data on clinical presentation, management, including mechanical circulatory support (MCS) were analysed comparing acute myocardial infarction (AMI) related CS and non-AMI-CS. The accuracy of CardShock and IABP-SHOCK II scores to assess 90 day mortality risk were also compared.

Results: A total of 382 CS patients were included, age 65.3 (SD 13.9) years, 75.1% men. Patients were classified as AMI-CS (n = 232, 60.7%) and non-AMI-CS (n = 150, 39.3%). In the AMI-CS group, 77.6% were STEMI. Main aetiologies for non-AMI-CS were heart failure (36.2%), arrhythmias (22.1%) and valve disease (8.0%). AMI-CS patients required more MCS than non-AMI-CS (43.1% vs. 16.7%, P < 0.001). In-hospital mortality was higher in AMI-CS (37.1 vs. 26.7%, P = 0.035), with a two-fold increased risk after multivariate adjustment (odds ratio 2.24, P = 0.019). The IABP-SHOCK II had superior discrimination for predicting 90 day mortality when compared with CardShock in AMI-CS patients [area under the curve (AUC) 0.74 vs. 0.66, P = 0.047] although both scores performed similarly in non-AMI-CS (AUC 0.64 vs. 0.62, P = 0.693).

Conclusions: In our cohort, AMI-CS mortality was increased by two-fold when compared with non-AMI-CS. IABP-SHOCK II score provides better 90 day mortality risk prediction than CardShock score in AMI-CS, but both scores performed similar in non-AMI-CS patients.

Keywords: cardiogenic shock; mortality; myocardial infarction; prognosis; risk score.

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Conflict of interest statement

None declared.

Figures

Figure 1
Figure 1
Aetiologies of cardiogenic shock in Shock‐CAT registry in acute myocardial infarction‐cardiogenic shock (AMI‐CS) (left) and non‐AMI‐CS (right).
Figure 2
Figure 2
CardShock and IABP Score accuracy for 90 day mortality in Shock‐CAT registry. Top figure: all cardiogenic shock (CS) patients. Down figures: depending on CS aetiology.
Figure 3
Figure 3
Central figure. The Shock‐CAT registry, main results and summary.
See this image and copyright information in PMC

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