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Published on: August 16, 2021
Cardiogenic Shock Due to Progressive Heart Failure-Clinical Characteristics and Outcomes Compared to Other
Dominik Krupka1, Michał Fułek2, Julia Drewniowska1
1Student Scientific Club of Transplantology and Advanced Therapies of Heart Failure, Institute of Heart Diseases, Faculty of Medicine, Wroclaw Medical University, 50-368 Wroclaw, Poland.
Insights
Cardiogenic shock (CS) from progressive heart failure (PHF) has distinct patient profiles and lower in-hospital mortality compared to other CS causes. Personalized treatment may improve outcomes for PHF patients.
Area of Science:
- Cardiology
- Critical Care Medicine
- Heart Failure Research
Background:
- Increasing prevalence of cardiogenic shock (CS) secondary to progressive heart failure (PHF).
- High mortality rates associated with CS.
- Need to differentiate CS etiologies for targeted management.
Purpose of the Study:
- To compare clinical characteristics and outcomes of CS patients due to PHF versus non-PHF causes.
- To identify distinct features of PHF-related CS.
- To evaluate mortality differences between CS subgroups.
Main Methods:
- Retrospective analysis of 280 patients with CS.
- Cohort divided into PHF (n=84) and non-PHF (n=196) groups.
- Comparison of clinical data, laboratory values, interventions, and mortality.
Main Results:
- PHF patients had higher rates of chronic kidney disease and valvular disease.
- PHF patients showed lower white blood cell counts and troponin T levels.
- In-hospital mortality was significantly lower in the PHF group (52% vs. 65%).
- Differences observed in mechanical circulatory support (MCS) types and fewer coronary revascularizations in PHF patients.
Conclusions:
- Patients with PHF-related CS have unique clinical profiles.
- PHF-related CS may be associated with lower in-hospital mortality with tailored treatment.
- Further prospective, multicenter studies are needed to optimize management strategies for this patient subgroup.
Abstract:
Background: The prevalence of cardiogenic shock (CS) resulting from the progression of heart failure (PHF) is increasing and remains associated with high mortality. This study aimed to compare the clinical characteristics and outcomes of patients who developed CS due to PHF versus those whose CS was caused by other aetiologies (non-PHF). Methods: We retrospectively analysed 280 patients admitted to a Polish tertiary care centre between January 2021 and April 2024. The cohort was divided into two groups: PHF (n = 84, 30%) and non-PHF (n = 196, 70%). Results: Compared to the non-PHF group, PHF patients more frequently had chronic kidney disease (30% vs. 15%, p < 0.01), and significant valvular disease (30% vs. 13%, p < 0.01). PHF patients exhibited significantly lower white blood cell counts (9.4 [6.9-16.4] vs. 13.3 [10.4-17.6], p < 0.01) and troponin T levels (188 [61-1392] vs. 10,921 [809-45,792], p < 0.01). In-hospital mortality was significantly lower among PHF patients (52% vs. 65%, p = 0.04). Although the overall use of mechanical circulatory support (MCS) did not differ between groups, significant differences in the types of MCS applied were observed (p < 0.01). Additionally, PHF patients underwent fewer coronary revascularisation procedures (15% vs. 70%, p < 0.01). Conclusions: Patients with PHF-related CS exhibit distinct clinical profiles and may experience lower in-hospital mortality when appropriately diagnosed and treated with a personalised approach. Further prospective, multicentre studies are warranted to optimize the management of this growing subgroup of CS patients.
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