Line Thorgaard Petersen1, Signe Riddersholm2, Dennis Christian Andersen1, Christoffer Polcwiartek1, Christina J-Y Lee3,4, Marie Dam Lauridsen5, Emil Fosbøl5, Christian Fynbo Christiansen6, Manan Pareek7,8,9, Peter Søgaard1, Christian Torp-Pedersen1,4,10, Bodil Steen Rasmussen11,12, Kristian Hay Kragholm1,13. 1. Department of Cardiology, Aalborg University Hospital, Hobrovej 18-22, 9000 Aalborg, Denmark. 2. Department of Medicine, Skovlyvej 15, 8930 Randers, Denmark. 3. Department of Cardiology, Copenhagen University Hospital, Herlev-Gentofte, Gentofte Hospitalsvej 1, 2900 Hellerup Denmark. 4. Department of Cardiology, Nordsjaellands Hospital, Dyrehavevej 29, 3400 Hilleroed, Denmark. 5. Department of Cardiology, Rigshospitalet University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark. 6. Department of Clinical Epidemiology, Aarhus University Hospital, Palle Juul-Jensens Blvd. 99, 8200 Skejby, Denmark. 7. Brigham and Women's Hospital, Heart & Vascular Center, Harvard Medical School, 75 Francis St, Boston, MA 02115, USA. 8. Department of Internal Medicine, Yale New Haven Hospital, Yale University School of Medicine, 20 York St, New Haven 06510, CT, USA. 9. Department of Cardiology and Clinical Epidemiology, North Zealand Hospital, Dyrehavevej 29, 3400 Hilleroed, Denmark. 10. Department of Public Health, University of Copenhagen, Noerregade 10, 1165 Copenhagen, Denmark. 11. Department of Anaesthesiology and Intensive Care Medicine, Aalborg University Hospital, Hobrogen 18-22, 9000 Alborg, Denmark. 12. Clinical Institute, Aalborg University, Soendre Skovvej 15, 9000 Alborg, Denmark. 13. Unit of Clinical Biostatistics and Epidemiology, Aalborg University Hospital, Hobrovej 18-22, 9000 Aalborg, Denmark.
Abstract
AIMS: Most cardiogenic shock (CS) studies focus on acute coronary syndrome (ACS). Contemporary data on temporal trends in patient characteristics, presumed causes, treatments, and outcomes of ACS- and in particular non-ACS-related CS patients are sparse. METHODS AND RESULTS: Using nationwide medical registries, we identified patients with first-time CS between 2005 and 2017. Cochrane-Armitage trend tests were used to examine temporal changes in presumed causes of CS, treatments, and outcomes. Among 14 363 CS patients, characteristics remained largely stable over time. As presumed causes of CS, ACS (37.1% in 2005 to 21.4% in 2017), heart failure (16.3% in 2005 to 12.0% in 2017), and arrhythmias (13.0% in 2005 to 10.9% in 2017) decreased significantly over time; cardiac arrest increased significantly (11.3% in 2005 to 24.5% in 2017); and changes in valvular heart disease were insignificant (11.5% in 2005 and 11.6% in 2017). Temporary left ventricular assist device, non-invasive ventilation, and extracorporeal membrane oxygenation use increased significantly over time; intra-aortic balloon pump and mechanical ventilation use decreased significantly. Over time, 30-day and 1-year mortality were relatively stable. Significant decreases in 30-day and 1-year mortality for patients presenting with ACS and arrhythmias and a significant increase in 1-year mortality in patients presenting with heart failure were seen. CONCLUSION: Between 2005 and 2017, we observed significant temporal decreases in ACS, heart failure, and arrhythmias as presumed causes of first-time CS, whereas cardiac arrest significantly increased. Although overall 30-day and 1-year mortality were stable, significant decreases in mortality for ACS and arrhythmias as presumed causes of CS were seen. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: Most cardiogenic shock (CS) studies focus on acute coronary syndrome (ACS). Contemporary data on temporal trends in patient characteristics, presumed causes, treatments, and outcomes of ACS- and in particular non-ACS-related CS patients are sparse. METHODS AND RESULTS: Using nationwide medical registries, we identified patients with first-time CS between 2005 and 2017. Cochrane-Armitage trend tests were used to examine temporal changes in presumed causes of CS, treatments, and outcomes. Among 14 363 CS patients, characteristics remained largely stable over time. As presumed causes of CS, ACS (37.1% in 2005 to 21.4% in 2017), heart failure (16.3% in 2005 to 12.0% in 2017), and arrhythmias (13.0% in 2005 to 10.9% in 2017) decreased significantly over time; cardiac arrest increased significantly (11.3% in 2005 to 24.5% in 2017); and changes in valvular heart disease were insignificant (11.5% in 2005 and 11.6% in 2017). Temporary left ventricular assist device, non-invasive ventilation, and extracorporeal membrane oxygenation use increased significantly over time; intra-aortic balloon pump and mechanical ventilation use decreased significantly. Over time, 30-day and 1-year mortality were relatively stable. Significant decreases in 30-day and 1-year mortality for patients presenting with ACS and arrhythmias and a significant increase in 1-year mortality in patients presenting with heart failure were seen. CONCLUSION: Between 2005 and 2017, we observed significant temporal decreases in ACS, heart failure, and arrhythmias as presumed causes of first-time CS, whereas cardiac arrest significantly increased. Although overall 30-day and 1-year mortality were stable, significant decreases in mortality for ACS and arrhythmias as presumed causes of CS were seen. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Dirk von Lewinski; Lukas Herold; Christian Stoffel; Sascha Pätzold; Friedrich Fruhwald; Siegfried Altmanninger-Sock; Ewald Kolesnik; Markus Wallner; Peter Rainer; Heiko Bugger; Nicolas Verheyen; Ursula Rohrer; Martin Manninger-Wünscher; Daniel Scherr; Dietmar Renz; Ameli Yates; Andreas Zirlik; Gabor G Toth Journal: Catheter Cardiovasc Interv Date: 2022-07-13 Impact factor: 2.585