Abstract
Abstract 15718: Higher In-Hospital Mortality Among Cardiogenic Shock Patients With De Novo versus Acute on Chronic Heart Failure
Circulation (New York, N.Y.), v 146(Suppl_1)
08 Nov 2022
Abstract
Abstract only
Introduction:
Heart failure cardiogenic shock (HF-CS) constitutes a heterogenous population and has been identified as the leading type of shock among contemporary intensive care units. The in-hospital trajectory of shock severity and its association with mortality and transition to heart replacement therapy (HRT) or native heart survival (NHS) based on HF-CS phenotype has not been well described.
Methods:
The Cardiogenic Shock Working Group (CSWG) registry includes patients from 17 hospitals between 2016 and 2021. For this analysis, HF-CS patients were sub-classified as having
de novo
HF-CS or acute-on-chronic (ACHF) CS. In-hospital trajectories were assessed using baseline and maximum Society for Cardiovascular Angiography and Interventions (SCAI) stages and clinical outcomes were analyzed.
Results:
A total of 1,767 patients with HF-CS were included. Of these, 349 had
de novo
HF-CS (19.8%) and 1,371 (77.6%) had ACHF-CS. Overall, patients with
de novo
HF-CS had greater in-hospital death (32% vs 22%), NHS (58% vs 45%) and less HRT (33% vs 10%) when compared to ACHF-CS (all p<0.001). These variances in clinical outcomes differ when analyzed according to SCAI stages, with more significant differences between
de novo
HF-CS vs. ACHF-CS across baseline and maximum SCAI Stages C-D
(Figure).
Conclusions:
Using a large contemporary real-world dataset of HF-CS, we identified that
de novo
HF-CS is associated with higher in-hospital mortality and NHS and lower HRT compared to ACHF-CS. These differences vary depending to SCAI Stage and are more pronounced in SCAI Stages C and D. Further efforts to define shock trajectories and to tailor therapeutics in HF-CS patients are urgently needed.
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Details
- Title
- Abstract 15718: Higher In-Hospital Mortality Among Cardiogenic Shock Patients With De Novo versus Acute on Chronic Heart Failure
- Creators
- Vanessa Blumer - Duke UniversityJaime Hernandez-Montfort - Temple, TXShashank S Sinha - Alaska Heart and Vascular InstituteManreet Kanwar - Pittsburgh, PAArthur Reshad Garan - Boston, MAYijing Zhang - Boston, MABORUI LI - Boston, MAPaulina Baca - Tufts Medical CenterFatou Dieng - Boston, MANeil Harwani - Greensboro CollegeDaniel Burkhoff - Remsenburg, NYNavin K Kapur - Tufts Medical Center
- Publication Details
- Circulation (New York, N.Y.), v 146(Suppl_1)
- Resource Type
- Abstract
- Language
- English
- Academic Unit
- Cardiology
- Other Identifier
- 991021932191204721