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BRIEF RESEARCH REPORT article

Front. Cardiovasc. Med.
Sec. Intensive Care Cardiovascular Medicine
Volume 11 - 2024 | doi: 10.3389/fcvm.2024.1509162
This article is part of the Research Topic Critical Care Cardiology for Cardiovascular Emergencies View all 8 articles

Can mechanical circulatory comprehensive approach to cardiogenic shock at referral centers reduce 30-day mortality?

Provisionally accepted
Marina Pieri Marina Pieri 1*Mario Iannaccone Mario Iannaccone 2Francesco Burzotta Francesco Burzotta 3giulia botti giulia botti 1Cristina Aurigemma Cristina Aurigemma 3Carlo Trani Carlo Trani 3Silvia Ajello Silvia Ajello 1Savino Altizio Savino Altizio 1Tommaso Sanna Tommaso Sanna 3Enrico Romagnoli Enrico Romagnoli 3Lazzaro Paraggio Lazzaro Paraggio 3Luigi Cappannoli Luigi Cappannoli 3Anna Mara Scandroglio Anna Mara Scandroglio 1Alaide Chieffo Alaide Chieffo 1
  • 1 San Raffaele Hospital (IRCCS), Milan, Italy
  • 2 Ospedale San Giovanni Bosco, Turin, Piedmont, Italy
  • 3 Agostino Gemelli University Policlinic, Rome, Lazio, Italy

The final, formatted version of the article will be published soon.

    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.

    Keywords: Cardiogenic shock, Mortality, risk score, Mechanical circulatory support, Impella, inotropes

    Received: 10 Oct 2024; Accepted: 27 Dec 2024.

    Copyright: © 2024 Pieri, Iannaccone, Burzotta, botti, Aurigemma, Trani, Ajello, Altizio, Sanna, Romagnoli, Paraggio, Cappannoli, Scandroglio and Chieffo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Marina Pieri, San Raffaele Hospital (IRCCS), Milan, Italy

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.