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

Karami, M.; Peters, E.J.; Lagrand, W.K.; Houterman, S.; Uil, C.A. den; Engstrom, A.E.; Otterspoor, L.C.; Ottevanger, J.P.; Ferreira, I.A.; Montero Cabezas, J.M.; Sjauw, K.; Ramshorst, J. van; Kraaijeveld, A.O.; Verouden, N.J.W.; Lipsic, E.; Vlaar, A.P.; Henriques, J.P.S.

doi:doi:10.3390/jcm10102047

Persistent URL of this record https://hdl.handle.net/1887/3279546

View statistics

In Collections

This item can be found in the following collections:

Medicine / Leiden University Medical Centre (LUMC)

Karami, M.; Peters, E.J.; Lagrand, W.K.; Houterman, S.; Uil, C.A. den; Engstrom, A.E.; ... ; Henriques, J.P.S. (2021)

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

Article / Letter to editor

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...Show moreIt 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.Show less

cardiogenic shock

percutaneous coronary intervention

acute coronary syndrome

clinical outcome

predictors