Related Experiment Video
Updated: Sep 3, 2025
Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
Published on: June 12, 2021
Cardiogenic Shock Does Not Portend Poor Long-Term Survival in Patients Undergoing Primary Percutaneous Coronary
Eva Steinacher1, Felix Hofer1, Niema Kazem1
1Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
Insights
Cardiogenic shock (CS) after acute coronary syndrome (ACS) does not impact long-term mortality. However, older patients with impaired left ventricular function and chronic kidney disease face increased long-term risks.
Area of Science:
- Cardiology
- Internal Medicine
- Clinical Research
Background:
- Cardiogenic shock (CS) is strongly linked to in-hospital mortality in acute coronary syndrome (ACS) patients.
- The long-term prognostic impact of CS following ACS requires further investigation.
Purpose of the Study:
- To evaluate the long-term effect of cardiogenic shock on cardiovascular mortality in patients with acute coronary syndrome.
- To identify subgroups of CS patients at higher risk for long-term adverse outcomes.
Main Methods:
- Retrospective analysis of 1173 patients undergoing primary percutaneous coronary interventions (1997-2009).
- Follow-up until the primary endpoint of cardiovascular mortality.
- Subgroup analysis based on age, left ventricular function, and chronic kidney disease.
Main Results:
- Of 1173 patients, 112 (10.4%) presented with CS.
- After initial survival, CS did not significantly impact overall long-term mortality (23.5% vs. 24.0%, p=0.923).
- CS patients aged ≥55 years with impaired left ventricular function and chronic kidney disease showed increased long-term cardiovascular mortality risk.
Conclusions:
- Cardiovascular survival in CS patients is comparable to non-CS patients after the acute phase.
- Older CS patients with impaired left ventricular function and chronic kidney disease require intensified secondary prevention strategies.
Abstract:
Although a strong association of cardiogenic shock (CS) with in-hospital mortality in patients with acute coronary syndrome (ACS) is well established, less attention has been paid to its prognostic influence on long-term outcome. We evaluated the impact of CS in 1173 patients undergoing primary percutaneous coronary interventions between 1997 and 2009. Patients were followed up until the primary study endpoint (cardiovascular mortality) was reached. Within the entire study population, 112 (10.4%) patients presented with CS at admission. After initial survival, CS had no impact on mortality (non-CS: 23.5% vs. CS: 24.0%; p = 0.923), with an adjusted hazard ratio of 1.18 (95% CI: 0.77-1.81; p = 0.457). CS patients ≥ 55 years (p = 0.021) with moderately or severely impaired left ventricular function (LVF; p = 0.039) and chronic kidney disease (CKD; p = 0.013) had increased risk of cardiovascular mortality during follow-up. The present investigation extends currently available evidence that cardiovascular survival in CS is comparable with non-CS patients after the acute event. CS patients over 55 years presenting with impaired LVF and CKD at the time of ACS are at increased risk for long-term mortality and could benefit from personalized secondary prevention.
More Related Videos
07:39Use of a Percutaneous Ventricular Assist Device/Left Atrium to Femoral Artery Bypass System for Cardiogenic Shock
Published on: August 16, 2021
05:41Left Anterior Descending Coronary Artery Ligation for Ischemia-Reperfusion Research: Model Improvement via Technical Modifications and Quality Control
Published on: December 16, 2022
Related Concept Videos
01:30Cardiomyopathy II: Dilated Cardiomyopathy
01:28Acute Coronary Syndrome IV: Interprofessional Care
01:25Cardiopulmonary Resuscitation IV: Pharmacological Management
01:29Cardiomyopathy V: Interprofessional Care
01:29Cardiomyopathy III: Hypertrophic Cardiomyopathy
01:30Acute Coronary Syndrome I: Introduction