Etiology and Prognosis of Cardiogenic Shock in a Secondary Center without Surgical Back-Up

Author:

Bonello Laurent123ORCID,Laine Marc123,Puymirat Etienne4,Ceccaldi Victoria123,Gaubert Mélanie123,Paganelli Franck123,Thuny Pr Franck123,Dabry Thibaut123,Schurtz Guillaume5,Delmas Clement67,Mancini Julien89,Lemesle Gilles5

Affiliation:

1. Assistance Publique-Hôpitaux de Marseille, Intensice Care Unit, Hôpital Nord, Marseille, France

2. Mediterranean Academic Association for Research and Studies in Cardiology (MARS Cardio), Marseille, France

3. Aix-Marseille University, INSERM UMRS 1076, Marseille, France

4. Département de Cardiologie, Hôpital Européen Georges Pompidou, Assistance Publique des Hôpitaux de Paris, Paris, France

5. USIC et Centre Hémodynamique, Institut Cœur Poumon, Centre Hospitalier Régional et Universitaire de Lille, Faculté de Médecine de l’Université de Lille, INSERM UMR1011, Lille F-59000, France

6. Intensive Cardiac Care Unit, Rangueil University Hospital, Toulouse, France

7. Institute of Metabolic and Cardiovascular Diseases (I2MC), Institut National de la Santé et de la Recherche Médicale (INSERM), UMR-1048, Toulouse, France

8. Aix-Marseille Univ, INSERM, IRD, UMR912, SESSTIM, “Cancers Biomedicine & Society” Group, Marseille, France

9. APHM, Timone Hospital, Public Health Department (BIOSTIC), Marseille, France

Abstract

Background. Cardiogenic shock (CS) remains a major challenge in contemporary cardiology. Data regarding CS etiologies and their prognosis are limited and mainly derived from tertiary referral centers. Aims. To investigate the current etiologies of cardiogenic shock and their associated short- and long-term outcomes in a secondary center without surgical back-up. Methods. We performed an observational prospective monocenter study. All patients admitted for a first episode of CS related to left ventricular dysfunction were enrolled. The definition of CS was consistent with the European Society of Cardiology guidelines. Patients were followed for 6 months. Etiologies were analyzed, and survival rates derived from Kaplan-Meier estimates were compared with the log-rank test. Results. Between January 2015 and January 2016, 152 patients were included. The first most common cause of CS was acute decompensation of chronic heart failure (CHF). Acute coronary syndromes (ACS) were the second most common cause of CS (35.4%). At one month, the all-cause mortality rate was 39.5% and was similar between ACS and CHF (43% vs 35%, respectively; p=0.7). In a landmark analysis between 1 and 6 months, we observed a significantly higher mortality in patients with CHF than in patients with ACS (18% vs. 0%; p=0.01). Conclusions. In the present registry, acute decompensation of chronic heart failure was the most common cause of CS, while ACS complicated by CS was the second most common cause. Of importance, acute decompensation of CHF was associated with a significantly worse outcome than ACS in the long term.

Funder

Mars Cardio Association

Publisher

Hindawi Limited

Subject

Cardiology and Cardiovascular Medicine

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3