Universität zu Köln

Tavazzi, Guido ORCID: 0000-0002-9560-5138, Rossello, Xavier ORCID: 0000-0001-6783-8463, Grand, Johannes ORCID: 0000-0002-5511-4668, Gierlotka, Marek, Sionis, Alessandro ORCID: 0000-0003-0843-9512, Ahrens, Ingo, Hassager, Christian and Price, Susanna ORCID: 0000-0002-6425-3360 (2022). Epidemiology, monitoring, and treatment strategy in cardiogenic shock. A multinational cross-sectional survey of ESC-acute cardiovascular care association research section. Eur. Heart J.-Acute Cardiovasc. Care, 11 (9). S. 706 - 712. OXFORD: OXFORD UNIV PRESS. ISSN 2048-8734

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Abstract

Aims Cardiogenic shock (CS) is a life-threatening condition burdened by mortality in up to 50% of cases. Few recommendations exist with intermediate-low level of evidence on CS management and no data on adherence across centres exist. We performed a survey to frame CS management at multinational level. Methods and results An international cross-sectional survey was created and approved by European Society of Cardiology-Acute Cardiovascular Care Association board. A total of 337 responses from 60 countries were obtained. Data were assessed by the hospital level of care of the participants. The most common cause of CS was AMI (AMI-CS-79.9%) with significant difference according to hospital levels (P = 0.001), followed by acutely decompensated heart failure (HF) (13.4%), myocarditis (3.5%), and de novo HF (1.75%). In 37.8%, percutaneous coronary intervention (PCI) is performed to all CS-patients as a standard approach, whereas 42.1% used PCI if electrocardiogram suggestive of ischaemia and 20.1% only if Universal definition of myocardial infarction criteria are fulfilled. Management (catecholamine titration and mechanical circulatory support escalation) is driven by mean arterial pressure (87.1%), echocardiography (84.4%), and lactate levels (83.4%). Combination of vasopressor and inotrope is chosen with the same frequency (37.7%) than inotrope alone as first-line pharmacological therapy (differences amongst hospital levels; P > 0.5). Noradrenaline is first-line vasopressor (89.9%) followed by dopamine (8.5%), whereas dobutamine is confirmed as the first-line inotrope (65.9%). Conclusion Cardiogenic shock management is heterogenous and often not adherent to current recommendations. Quality improvement on an international level with evidence-based quality indicators should be developed to standardize diagnostic and therapeutic pathways.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Tavazzi, Guido UNSPECIFIED orcid.org/0000-0002-9560-5138 UNSPECIFIED Rossello, Xavier UNSPECIFIED orcid.org/0000-0001-6783-8463 UNSPECIFIED Grand, Johannes UNSPECIFIED orcid.org/0000-0002-5511-4668 UNSPECIFIED Gierlotka, Marek UNSPECIFIED UNSPECIFIED UNSPECIFIED Sionis, Alessandro UNSPECIFIED orcid.org/0000-0003-0843-9512 UNSPECIFIED Ahrens, Ingo UNSPECIFIED UNSPECIFIED UNSPECIFIED Hassager, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Price, Susanna UNSPECIFIED orcid.org/0000-0002-6425-3360 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-693677
DOI:	10.1093/ehjacc/zuac087
Journal or Publication Title:	Eur. Heart J.-Acute Cardiovasc. Care
Volume:	11
Number:	9
Page Range:	S. 706 - 712
Date:	2022
Publisher:	OXFORD UNIV PRESS
Place of Publication:	OXFORD
ISSN:	2048-8734
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language TERM MORTALITY Multiple languages Cardiac & Cardiovascular Systems Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/69367