Journal article
Criteria for Defining Stages of Cardiogenic Shock Severity
Journal of the American College of Cardiology, v 80(3), pp 185-198
19 Jul 2022
PMID: 35835491
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
BACKGROUND Risk-stratifying patients with cardiogenic shock (CS) is a major unmet need. The recently proposed Society for Cardiovascular Angiography and Interventions (SCAI) staging system for CS severity lacks uniform criteria defining each stage. OBJECTIVES The purpose of this study was to test parameters that define SCAI stages and explore their utility as predictors of in-hospital mortality in CS. METHODS The CS Working Group registry includes patients from 17 hospitals enrolled between 2016 and 2021 and was used to define clinical profiles for CS. We selected parameters of hypotension and hypoperfusion and treatment intensity, confirmed their association with mortality, then defined formal criteria for each stage and tested the association between both baseline and maximum Stage and mortality. RESULTS Of 3,455 patients, CS was caused by heart failure (52%) or myocardial infarction (32%). Mortality was 35% for the total cohort and higher among patients with myocardial infarction, out-of-hospital cardiac arrest, and treatment with increasing numbers of drugs and devices. Systolic blood pressure, lactate level, alanine transaminase level, and systemic pH were significantly associated with mortality and used to define each stage. Using these criteria, baseline and maximum stages were significantly associated with mortality (n = 1,890). Lower baseline stage was associated with a higher incidence of stage escalation and a shorter duration of time to reach maximum stage. CONCLUSIONS We report a novel approach to define SCAI stages and identify a significant association between baseline and maximum stage and mortality. This approach may improve clinical application of the staging system and provides new insight into the trajectory of hospitalized CS patients. (Cardiogenic Shock Working Group Registry [CSWG]; NCT04682483) (C) 2022 Published by Elsevier on behalf of the American College of Cardiology Foundation.
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Details
- Title
- Criteria for Defining Stages of Cardiogenic Shock Severity
- Creators
- Navin K. Kapur - Tufts Medical CenterManreet Kanwar - Allegheny Health NetworkShashank S. Sinha - Inova Fairfax HospitalKatherine L. Thayer - Tufts Medical CenterA. Reshad Garan - Beth Israel Deaconess Medical CenterJaime Hernandez-Montfort - Baylor Scott & White HealthYijing Zhang - Tufts Medical CenterBorui Li - Tufts Medical CenterPaulina Baca - Tufts Medical CenterFatou Dieng - Tufts Medical CenterNeil M. Harwani - Tufts Medical CenterJacob Abraham - Providence CollegeGavin Hickey - University of Pittsburgh Medical CenterSandeep Nathan - University of ChicagoDetlef Wencker - Baylor Scott & White HealthShelley Hall - Baylor Scott & White HealthAndrew Schwartzman - Maine Medical CenterWissam Khalife - The University of Texas Medical Branch at GalvestonSong Li - University of Washington Medical CenterClaudius Mahr - University of Washington Medical CenterJu H. Kim - Houston MethodistEsther Vorovich - College Station Medical CenterEvan H. Whitehead - Massachusetts Gen Hosp, Boston, MA USAVanessa Blumer - Duke UniversityDaniel Burkhoff - Cardiovasc Res Fdn, New York, NY USA
- Publication Details
- Journal of the American College of Cardiology, v 80(3), pp 185-198
- Publisher
- Elsevier
- Number of pages
- 14
- Grant note
- Medtronic CSI Verantos Boston Scientific Inc; Boston Scientific Abbott Laboratories R01HL139 785-01; R01HL159089-01 / National Institutes of Health; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA LivaNova LivaNova Inc Abiomed Inc. Abbott; Abbott Laboratories
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Cardiology
- Web of Science ID
- WOS:000829779500001
- Scopus ID
- 2-s2.0-85133183224
- Other Identifier
- 991021932190804721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Cardiac & Cardiovascular Systems