Can a mechanical circulatory support comprehensive approach to cardiogenic shock at referral centers reduce 30-day mortality?
Although mortality risk prediction in cardiogenic shock (CS) is possible, assessing the impact of the multitude of therapeutic efforts on outcomes is not straightforward. We assessed whether a temporary mechanical circulatory support comprehensive approach to the treatment of CS may reduce 30-day mo...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2024.1509162/full |
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| author | Marina Pieri Marina Pieri Mario Iannaccone Francesco Burzotta Francesco Burzotta Giulia Botti Giulia Botti Cristina Aurigemma Carlo Trani Carlo Trani Silvia Ajello Savino Altizio Tommaso Sanna Tommaso Sanna Enrico Romagnoli Lazzaro Paraggio Luigi Cappannoli Anna Mara Scandroglio Alaide Chieffo Alaide Chieffo |
| author_facet | Marina Pieri Marina Pieri Mario Iannaccone Francesco Burzotta Francesco Burzotta Giulia Botti Giulia Botti Cristina Aurigemma Carlo Trani Carlo Trani Silvia Ajello Savino Altizio Tommaso Sanna Tommaso Sanna Enrico Romagnoli Lazzaro Paraggio Luigi Cappannoli Anna Mara Scandroglio Alaide Chieffo Alaide Chieffo |
| author_sort | Marina Pieri |
| collection | DOAJ |
| description | Although mortality risk prediction in cardiogenic shock (CS) is possible, assessing the impact of the multitude of therapeutic efforts on outcomes is not straightforward. We assessed whether a temporary mechanical circulatory support comprehensive approach to the treatment of CS may reduce 30-day mortality as compared to expected mortality predicted by the recently proposed Cardiogenic Shock Score (CSS). Consecutive CS patients supported by pVAD Impella (Abiomed, Danvers, MA) at two national referral centers were included. 170 patients were included: age was 65 ± 13 years, and 75.9% were male and acute myocardial infarction was the prevalent cause of shock (71.1%). Expected mortality according to CSS was higher than observed (51.8% vs. 41.5%, p < 0.001), this trend being particularly evident for CSS > 4. The AUC ROC curve confirmed poor diagnostic accuracy in this population (AUC 0.53 CI: 0.23–0.82, p = 0.83). The lower observed mortality compared to the expected mortality in critical cardiogenic shock population underscores the role of a comprehensive approach to acute cardiac care patients at referral centers, which should consider including temporary mechanical circulatory support. |
| format | Article |
| id | doaj-art-e369f8eebbd94f8187a2288fc4f51755 |
| institution | Kabale University |
| issn | 2297-055X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj-art-e369f8eebbd94f8187a2288fc4f517552025-01-16T16:04:43ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-01-011110.3389/fcvm.2024.15091621509162Can a mechanical circulatory support comprehensive approach to cardiogenic shock at referral centers reduce 30-day mortality?Marina Pieri0Marina Pieri1Mario Iannaccone2Francesco Burzotta3Francesco Burzotta4Giulia Botti5Giulia Botti6Cristina Aurigemma7Carlo Trani8Carlo Trani9Silvia Ajello10Savino Altizio11Tommaso Sanna12Tommaso Sanna13Enrico Romagnoli14Lazzaro Paraggio15Luigi Cappannoli16Anna Mara Scandroglio17Alaide Chieffo18Alaide Chieffo19Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, ItalySchool of Medicine, Vita-Salute San Raffaele University, Milan, ItalyDepartment of Cardiology, San Giovanni Bosco Hospital, ASL Città di Torino, Turin, ItalySchool of Medicine, Università Cattolica del Sacro Cuore, Rome, ItalyDepartment of Cardiovascular Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, ItalySchool of Medicine, Vita-Salute San Raffaele University, Milan, ItalyInterventional Cardiology Unit, IRCCS San Raffaele Scientific Institute, Milan, ItalyDipartimento CUORE, Fondazione Policlinico Univeristario A. Gemelli IRCCS Roma, Rome, ItalySchool of Medicine, Università Cattolica del Sacro Cuore, Rome, ItalyDepartment of Cardiovascular Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, ItalyDepartment of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, ItalyDepartment of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, ItalySchool of Medicine, Università Cattolica del Sacro Cuore, Rome, ItalyDepartment of Cardiovascular Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, ItalyDepartment of Cardiovascular Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, ItalyDepartment of Cardiovascular Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, ItalyDepartment of Cardiovascular Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, ItalyDepartment of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, ItalySchool of Medicine, Vita-Salute San Raffaele University, Milan, ItalyInterventional Cardiology Unit, IRCCS San Raffaele Scientific Institute, Milan, ItalyAlthough mortality risk prediction in cardiogenic shock (CS) is possible, assessing the impact of the multitude of therapeutic efforts on outcomes is not straightforward. We assessed whether a temporary mechanical circulatory support comprehensive approach to the treatment of CS may reduce 30-day mortality as compared to expected mortality predicted by the recently proposed Cardiogenic Shock Score (CSS). Consecutive CS patients supported by pVAD Impella (Abiomed, Danvers, MA) at two national referral centers were included. 170 patients were included: age was 65 ± 13 years, and 75.9% were male and acute myocardial infarction was the prevalent cause of shock (71.1%). Expected mortality according to CSS was higher than observed (51.8% vs. 41.5%, p < 0.001), this trend being particularly evident for CSS > 4. The AUC ROC curve confirmed poor diagnostic accuracy in this population (AUC 0.53 CI: 0.23–0.82, p = 0.83). The lower observed mortality compared to the expected mortality in critical cardiogenic shock population underscores the role of a comprehensive approach to acute cardiac care patients at referral centers, which should consider including temporary mechanical circulatory support.https://www.frontiersin.org/articles/10.3389/fcvm.2024.1509162/fullcardiogenic shockmortalityrisk scoremechanical circulatory supportImpellainotropes |
| spellingShingle | Marina Pieri Marina Pieri Mario Iannaccone Francesco Burzotta Francesco Burzotta Giulia Botti Giulia Botti Cristina Aurigemma Carlo Trani Carlo Trani Silvia Ajello Savino Altizio Tommaso Sanna Tommaso Sanna Enrico Romagnoli Lazzaro Paraggio Luigi Cappannoli Anna Mara Scandroglio Alaide Chieffo Alaide Chieffo Can a mechanical circulatory support comprehensive approach to cardiogenic shock at referral centers reduce 30-day mortality? Frontiers in Cardiovascular Medicine cardiogenic shock mortality risk score mechanical circulatory support Impella inotropes |
| title | Can a mechanical circulatory support comprehensive approach to cardiogenic shock at referral centers reduce 30-day mortality? |
| title_full | Can a mechanical circulatory support comprehensive approach to cardiogenic shock at referral centers reduce 30-day mortality? |
| title_fullStr | Can a mechanical circulatory support comprehensive approach to cardiogenic shock at referral centers reduce 30-day mortality? |
| title_full_unstemmed | Can a mechanical circulatory support comprehensive approach to cardiogenic shock at referral centers reduce 30-day mortality? |
| title_short | Can a mechanical circulatory support comprehensive approach to cardiogenic shock at referral centers reduce 30-day mortality? |
| title_sort | can a mechanical circulatory support comprehensive approach to cardiogenic shock at referral centers reduce 30 day mortality |
| topic | cardiogenic shock mortality risk score mechanical circulatory support Impella inotropes |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2024.1509162/full |
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