European Heart Journal: Acute Cardiovascular Care最新文献

{"title":"Clinical characteristics, management, and predictors of mortality: results from the national prospective cardiogenic shock registry (CZECH-SHOCK).","authors":"Michal Pazdernik, Petr Ostadal, Jiri Seiner, Jan Pudil, Anna Chaloupka, Martin Novak, Eva Lichnerova, Radek Pelouch, Dagmar Vondrakova, Aneta Dvorakova, David Foral, Ales Kovarik, Tomas Hnat, Ahmad Zohoor, Adam Pocarovsky, Aneta Hainzova, Jan Matejka, Ondrej Sirotek, Anna Valerianova, Martin Vojtisek, Jan Precek, Peter Misun, Marek Sramko, Jan Mares, Jan Belohlavek","doi":"10.1093/ehjacc/zuaf034","DOIUrl":"10.1093/ehjacc/zuaf034","url":null,"abstract":"<p><strong>Aims: </strong>Only limited epidemiological data exist from national or international prospective multicentre registries covering the whole spectrum of cardiogenic shock (CS) aetiologies.</p><p><strong>Methods and results: </strong>A national prospective multicentre observational study, CZECH-SHOCK, was conducted in 15 main tertiary care centres in Czechia over a 12 month period from March 2023 to February 2024. A total of 418 patients with a median age of 70 (interquartile range 59-76) years were enrolled. The majority of patients was males (69.6%). A newly developed heart failure was observed in 76.8% patients, and acute myocardial infarction complicated by CS was the most frequent cause of a CS episode (56.7%). Mechanical circulatory support devices were utilized in 28.2% of cases. A 30 day mortality was 39.5%. In a multivariate analysis, six independent factors were associated with a higher 30 day mortality: age [odds ratio (OR) per 10-year increase: 1.78, 95% confidence interval (CI): 1.45-2.19], history of coronary artery disease (OR: 2.38, 95% CI: 1.41-4.30), history of chronic obstructive pulmonary disease (OR: 2.58, 95% CI: 1.27-5.25), Society for Cardiovascular Angiography and Interventions class on admission (OR per one class increase: 1.64, 95% CI: 1.27-2.11), renal replacement therapy during in-hospital stay (OR: 2.46, 95% CI: 1.32-4.59), and new mechanical ventilation after admission (OR: 4.58, 95% CI: 2.50-8.39).</p><p><strong>Conclusion: </strong>Acute myocardial infarction complicated by CS still represents the most frequent cause of CS episodes. The in-hospital mortality of patients with CS remains high, despite frequent utilization of haemodynamic support and organ replacement therapies.</p>","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"359-363"},"PeriodicalIF":3.9,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The pursuit of precision in cardiogenic shock: navigating promise, pitfalls, and a path forward.","authors":"Vanessa Blumer, Ajar Kochar, Shashank S Sinha","doi":"10.1093/ehjacc/zuaf080","DOIUrl":"10.1093/ehjacc/zuaf080","url":null,"abstract":"","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"313-317"},"PeriodicalIF":3.9,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decongestion strategies in acute heart failure: contrasting opinions from two leading experts.","authors":"Alessandro Galluzzo, Janine Pöss, Frederik Hendrik Verbrugge","doi":"10.1093/ehjacc/zuaf059","DOIUrl":"10.1093/ehjacc/zuaf059","url":null,"abstract":"","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"379-381"},"PeriodicalIF":3.9,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bringing heart care home: management of acute cardiovascular pathologies in the Home Hospital.","authors":"Abraham Cherukara, Lawrence Rudski, Michelle Grinman, David M Levine","doi":"10.1093/ehjacc/zuaf053","DOIUrl":"10.1093/ehjacc/zuaf053","url":null,"abstract":"<p><p>The Home Hospital (HH) model delivers hospital-level acute care in patients' homes, offering a scalable, patient-centred alternative to traditional brick-and-mortar facilities. By integrating multidisciplinary teams, remote monitoring, and tailored interventions, HH reduces hospital length of stay, enhances patient satisfaction, and lowers healthcare costs. Despite these benefits, universally established diagnosis-specific management guidelines remain limited, leading to variability in care delivery. Current practices rely on clinical experience and governing protocols, but structured HH pathways must be developed based on system-dependent resources and infrastructure. Standardizing care in HH will allow to ensure patient safety, optimize clinical outcomes, and expand access to acute care beyond conventional hospital settings. This article outlines a blueprint for acute cardiac care in HH, focusing on heart failure, atrial arrhythmias, and venous thromboembolism while emphasizing the critical role of patient selection, recruitment strategies, management protocols, and escalation criteria.</p>","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"364-374"},"PeriodicalIF":3.9,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Model for end-stage liver disease incorporating albumin score is associated with short- and long-term all-cause mortality in patients with acute myocardial infarction complicated by cardiogenic shock.","authors":"Zakaria Alaoui-Ismaili, Joakim Bo Kunkel, Anika Klein, Jakob Josiassen, Ole Kristian Lerche Helgestad, Karoline Korsholm Jeppesen, Henrik Schmidt, Lene Holmvang, Peter Laursen Graversen, Emil Fosbøl, Hanne Berg Ravn, Lisette Okkels Jensen, Jacob Eifer Møller, Christian Hassager","doi":"10.1093/ehjacc/zuaf063","DOIUrl":"10.1093/ehjacc/zuaf063","url":null,"abstract":"<p><strong>Aims: </strong>Liver injury is a frequent complication in patients with acute myocardial infarction complicated by cardiogenic shock (AMICS). The model for end-stage liver disease incorporating albumin (MELD-albumin) quantifies liver injury. This study assesses the association between MELD-albumin score and all-cause mortality among patients with AMICS.</p><p><strong>Methods and results: </strong>From a retrospective cohort of 1716 consecutive patients with AMICS admitted between 2010 and 2017, we included patients who survived until Day 3 and had complete laboratory data available (n = 717). The MELD-albumin was calculated using 0 to 72 h peak s-bilirubin and s-creatinine values and the lowest s-albumin value. Patients were stratified into tertiles: low, intermediate, and high MELD-albumin. The primary outcome was all-cause mortality with a follow-up of up to 14 years. Patients in the high-score group were more often female, had lower left ventricular ejection fraction, had higher lactate levels, and less suffered out-of-hospital cardiac arrest. The high-score group had a significantly higher all-cause mortality rate than the intermediate- and low-score groups at 30 days (49 vs. 35 vs. 26%, P < 0.001) and 10 years for 30-day survivors (58 vs. 46 vs. 37%, P < 0.001). Adjusted hazard ratios for mortality in the high-score group were 2.02 at 30 days [95% confidence interval (CI): 1.49-2.74, P < 0.001] and 1.86 at 10 years (95% CI: 1.18-2.92, P < 0.001). The MELD-albumin score demonstrated an area under the receiver operating curve of 0.63 (95% CI: 0.59-0.67) for predicting 30-day mortality.</p><p><strong>Conclusion: </strong>Liver injury, quantified as MELD-albumin score, was significantly associated with short- and long-term all-cause mortality among patients with AMICS.</p>","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"342-350"},"PeriodicalIF":3.9,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Answer: Silent stenosis to sudden shock: the unplanned culprit.","authors":"Narendran Dhanasekaran, Bharath Raj Kidambi, Yeriswamy Mogalahally Channabasappa","doi":"10.1093/ehjacc/zuaf030","DOIUrl":"10.1093/ehjacc/zuaf030","url":null,"abstract":"","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"377-378"},"PeriodicalIF":3.9,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Femoral vs. radial approach for primary percutaneous intervention in cardiogenic shock: a subanalysis from the ECLS-SHOCK trial.","authors":"Mohammad Abumayyaleh, Holger Thiele, Tienush Rassaf, Amir Abbas Mahabadi, Ralf Lehmann, Ingo Eitel, Carsten Skurk, Peter Clemmensen, Marcus Hennersdorf, Ingo Voigt, Axel Linke, Eike Tigges, Peter Nordbeck, Christian Jung, Philipp Lauten, Hans-Josef Feistritzer, Janine Pöss, Taoufik Ouarrak, Steffen Schneider, Michael Behnes, Daniel Duerschmied, Steffen Desch, Anne Freund, Uwe Zeymer, Ibrahim Akin","doi":"10.1093/ehjacc/zuaf035","DOIUrl":"10.1093/ehjacc/zuaf035","url":null,"abstract":"<p><strong>Aims: </strong>Cardiogenic shock (CS) is a life-threatening complication of acute coronary syndromes. Early revascularization with treating the culprit lesion improves survival. Nevertheless, the impact of access site (femoral vs. radial) on outcomes in infarct-related CS also in conjunction with extracorporeal life support (ECLS) remains unclear.</p><p><strong>Methods and results: </strong>This subanalysis of the ECLS-SHOCK trial included patients with infarct-related CS treated with or without ECLS, divided into femoral and radial access groups. The primary endpoint was 30-day mortality. Secondary endpoints included renal replacement therapy, repeat revascularization, reinfarction, rehospitalization for congestive heart failure, and poor neurological outcome (Cerebral Performance Categories 3-5) within 30 days. Safety outcomes included bleeding and peripheral vascular complications. Among 415 patients, percutaneous coronary intervention was initially intended through femoral (n = 304; 72.9%) or radial (n = 111; 26.6%) access. In the intended access site analysis, 25 patients (22.5%) in the radial group switched to femoral access, while 3 patients (1%) in the femoral group switched to radial access prior to or after coronary angiography. At 30 days, the overall mortality rate was higher in the femoral group compared with the radial group (52.0 vs. 37.8%) with a relative risk (RR) of 1.37, a 95% confidence interval (CI) of 1.06-1.78, and a P-value of 0.011 with no significant differences in the crude rates of secondary and safety endpoints. In the analysis based on the actual access site (as opposed to intended access site used), 7.8% of patients in the ECLS arm switched from radial to femoral, while 7.5% of patients in the conservative arm switched from radial to femoral for or after coronary angiography. Mortality rates were higher in the femoral group for both ECLS arm (52.7 vs. 26.8%; P = 0.003; RR, 1.96; 95% CI, 1.16-3.32) and conservative arm (52.2 vs. 37.5%; P = 0.074; RR, 1.39; 95% CI, 0.94-2.06). In a multivariate analysis, femoral access was associated with a trend for predicting adjusted 30-day mortality (RR, 1.22; 95% CI, 0.95-1.55; P = 0.11).</p><p><strong>Conclusion: </strong>In myocardial infarction-related CS, nearly one-fifth of patients with intended radial access switched to femoral. In multivariate analysis, femoral access was associated with a trend to adversely affect 30-day mortality.</p>","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"351-358"},"PeriodicalIF":3.9,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of patients with cancer admitted with heart failure-associated cardiogenic shock.","authors":"Olivia Liu, Steven Soo, Michelle Bloom, Jose Alvarez-Cardona, Jason N Katz, Richard K Cheng, Eric H Yang, Orly Leiva","doi":"10.1093/ehjacc/zuaf027","DOIUrl":"10.1093/ehjacc/zuaf027","url":null,"abstract":"<p><strong>Aims: </strong>Acute decompensated heart failure (HF) can progress to cardiogenic shock, and patients with cancer are at an increased risk of HF compared with patients without cancer. However, limited data exist on outcomes of patients admitted for HF-related cardiogenic shock (HF-CS) with cancer vs. without cancer.</p><p><strong>Methods and results: </strong>Adult patients admitted for HF-CS between 2014 and 2020 were identified using the National Readmission Database. Propensity score matching (PSM) was used to match 1 patient with cancer to 10 patients without cancer. Primary outcomes were in-hospital death, major bleeding, and thrombotic complications. Exploratory outcomes were 90-day readmission rates among patients who survived initial hospitalization. Temporal trends were also explored. Of the 137 316 admissions for HF-CS, 7306 (5.3%) had active cancer. After PSM, patients with cancer had increased odds of in-hospital death [odds ratio (OR) 1.12, 95% confidence interval (CI) 1.06-1.18], thrombotic complications (OR 1.12, 95% CI 1.03-1.21), and major bleeding (OR 1.23, 95% CI 1.17-1.31) compared with patients without cancer, with risks differing by cancer type. In exploratory analyses, rates of readmission were similar for patients with and without cancer. From 2014 to 2020, patients with cancer had no significant change in in-hospital mortality (Ptrend = 0.43), while patients without cancer had decreased mortality over time (Ptrend < 0.001).</p><p><strong>Conclusion: </strong>Among patients admitted for HF-CS, patients with cancer are at increased risk of in-hospital death, thrombotic complications, and major bleeding compared with patients without cancer. Future studies are needed to guide nuanced evaluation and management of this population to improve outcomes.</p>","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"318-326"},"PeriodicalIF":3.9,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143491386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pioneering progress in cardiogenic shock: a bold leap into the future of acute cardiovascular care.","authors":"Pascal Vranckx, David A Morrow, Sean van Diepen, Frederik H Verbrugge","doi":"10.1093/ehjacc/zuaf078","DOIUrl":"https://doi.org/10.1093/ehjacc/zuaf078","url":null,"abstract":"","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":"14 6","pages":"311-312"},"PeriodicalIF":3.9,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144552694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Question: Silent stenosis to sudden shock: the unplanned culprit.","authors":"Narendran Dhanasekaran, Bharath Raj Kidambi, Yeriswamy Mogalahally Channabasappa","doi":"10.1093/ehjacc/zuaf029","DOIUrl":"10.1093/ehjacc/zuaf029","url":null,"abstract":"","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"375-376"},"PeriodicalIF":3.9,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}