Ten-year trends in characteristics, management and outcomes of patients admitted with cardiogenic shock in the ACTION-SHOCK cohort

IF 2.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Archives of Cardiovascular Diseases Pub Date : 2024-10-01 DOI:10.1016/j.acvd.2024.07.059

David Sulman , Frederic Beaupré , Perrine Devos , Niki Procopi , Mathieu Kerneis , Paul Guedeney , Olivier Barthélémy , Anthony Elhadad , Stephanie Rouanet , Delphine Brugier , Guillaume Hekimian , Juliette Chommeloux , Alain Combes , Johanne Silvain , Jean-Philippe Collet , Gilles Montalescot , Michel Zeitouni , for the ACTION group

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引用次数: 0

Abstract

Background

The ACTION-SHOCK registry offers a decade-long perspective on patients admitted with cardiogenic shock (CS).

Aims

To assess trends in the management and outcomes of patients with CS over 10 years.

Methods

Trends in the characteristics, management and outcomes of patients with CS admitted into the cardiac intensive care unit of Pitié-Salpêtrière hospital from 2011 to 2020 were analysed. Short-term outcomes included in-hospital mortality, heart transplantation or ventricular assist device. Long-term outcomes were all-cause death or readmission for acute heart failure at 1 year.

Results

Over a 10-year period, data from 700 patients with CS (median [interquartile range] age 61 [50–72] years; 73% of men) were analysed. The proportion of CS related to acute myocardial infarction decreased (from 45% in 2011–2012 to 27% in 2019–2020) while the proportions related to chronic coronary syndrome (18% to 23%) and non-ischaemic cardiomyopathies (37 to 51%) increased (P < 0.01). The use of rescue extracorporeal membrane oxygenation remained stable (19 to 14%) and intra-aortic balloon pump use decreased (22% to 7%) (P < 0.01). In-hospital mortality remained stable (27 to 29%) as did the proportions of patients discharged after transplantation (17 to 14%) or with a durable ventricular assist device (2 to 4%). Among patients discharged alive, death or readmission for acute heart failure at 1 year remained high (37 to 47%).

Conclusion

CS remained associated with a poor prognosis over the last decade. There are significant unmet needs in the management strategies of patients with CS.

Abstract Image

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ACTION-SHOCK队列中心源性休克患者的特征、管理和预后的十年趋势

ACTION-SHOCK 登记为心源性休克（CS）患者提供了一个长达十年的视角。评估十年来心源性休克患者的管理和预后趋势。分析了2011年至2020年入住Pitié-Salpêtrière医院心脏重症监护室的CS患者的特征、管理和预后趋势。短期结果包括院内死亡率、心脏移植或心室辅助装置。长期结果为全因死亡或因急性心力衰竭一年后再次入院。在 10 年间，对 700 名 CS 患者（中位数[四分位间]年龄为 61 [50-72] 岁；73% 为男性）的数据进行了分析。与急性心肌梗死相关的CS比例有所下降（从2011-2012年的45%降至2019-2020年的27%），而与慢性冠状动脉综合征（18%至23%）和非缺血性心肌病（37%至51%）相关的比例有所上升（<0.01）。抢救性体外膜肺氧合的使用率保持稳定（从19%降至14%），主动脉内球囊泵的使用率有所下降（从22%降至7%）（<0.01）。院内死亡率保持稳定（27%至29%），移植后出院（17%至14%）或使用耐用心室辅助装置（2%至4%）的患者比例也保持稳定。在存活出院的患者中，1年内因急性心力衰竭死亡或再次入院的比例仍然很高（37% 至 47%）。在过去十年中，CS 的预后仍然很差。在 CS 患者的管理策略方面仍有大量需求未得到满足。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Archives of Cardiovascular Diseases 医学-心血管系统

CiteScore

4.40

自引率

6.70%

发文量

审稿时长

34 days

期刊介绍： The Journal publishes original peer-reviewed clinical and research articles, epidemiological studies, new methodological clinical approaches, review articles and editorials. Topics covered include coronary artery and valve diseases, interventional and pediatric cardiology, cardiovascular surgery, cardiomyopathy and heart failure, arrhythmias and stimulation, cardiovascular imaging, vascular medicine and hypertension, epidemiology and risk factors, and large multicenter studies. Archives of Cardiovascular Diseases also publishes abstracts of papers presented at the annual sessions of the Journées Européennes de la Société Française de Cardiologie and the guidelines edited by the French Society of Cardiology.