Association between pre-existing heart failure and in-hospital outcomes and management in admissions with cardiogenic

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Updated: Mar 24, 2026

Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
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Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock

Published on: June 12, 2021

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Carlos Diaz-Arocutipa1, Rafael Salguero-Bodes2,3,4, Roberto Martín-Asenjo2,3

  • 1Unidad de Revisiones Sistemáticas y Meta-análisis (URSIGET), Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru.

Expert Review of Cardiovascular Therapy
|March 23, 2026
PubMed

Insights

Patients with cardiogenic shock and preexisting heart failure had lower mortality but required more interventions and resources. This highlights the need for tailored management strategies for this specific patient group.

Area of Science:

  • Cardiology
  • Critical Care Medicine
  • Health Services Research

Background:

  • Cardiogenic shock (CS) is a life-threatening condition with high mortality.
  • The impact of preexisting heart failure (HF) on CS outcomes and management remains unclear.

Purpose of the Study:

  • To investigate the association between preexisting heart failure and outcomes in patients hospitalized with cardiogenic shock.
  • To analyze differences in management strategies and resource utilization based on HF status.

Main Methods:

  • Retrospective analysis of the 2016-2019 National Inpatient Sample.
  • Inclusion of adult patients hospitalized with cardiogenic shock.
  • Categorization based on the presence of preexisting heart failure.
  • Multivariable logistic regression to adjust for confounding factors.

Main Results:

  • Of 640,660 CS admissions, 65.4% had HF. Patients with HF were older, had more comorbidities, and were more likely treated in urban teaching hospitals.
  • Preexisting HF was associated with significantly lower in-hospital mortality (aOR 0.58).
  • HF patients experienced greater utilization of pulmonary artery catheterization (aOR 1.76), mechanical circulatory support (aOR 1.33), and renal replacement therapy (aOR 1.11), with longer hospital stays and higher charges, but less major bleeding.

Conclusions:

  • Preexisting heart failure defines a distinct cardiogenic shock phenotype.
  • This phenotype is characterized by reduced in-hospital mortality but increased resource utilization.
  • Phenotype-specific management strategies and improved risk stratification models are crucial for optimizing cardiogenic shock care.
Abstract

Keywords:
Cardiogenic shockheart failurehemodynamic monitoringmechanical circulatory supportmortality

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