Author + information
- Lavone Smith,
- Anthony Peters,
- Paul Corotto,
- Travis Moss,
- Kenneth Bilchick and
- Sula Mazimba
Background: The impact of cardiogenic shock (CS) on survival in patients hospitalized for acute decompensated heart failure (ADHF) in the present day coronary care unit (CCU) with current options for mechanical circulatory support (MCS) is of particular interest.
Methods: We evaluated outcomes in 260 patients admitted to our CCU between 2011 and 2013 with ADHF with and without CS using Kaplan-Meier survival analysis and multivariable Cox proportional hazards regression. Patients were categorized as no CS, CS without MCS, and CS with temporary MCS such as intra-aortic balloon pump.
Results: Among 260 patients with ADHF (mean age 66.4 ± 13.8 years, 39.6% female), 160 patients had ADHF without CS, 87 patients had ADHF with CS, and 13 patients had ADHF with CS and temporary MCS (followed by durable left ventricular assist device (LVAD) implant in 38.5%). Survival to hospital discharge occurred in 76.9% with CS and MCS, 58.6% with CS without MCS, and 91.9% with ADHF without CS. Survival to hospital discharge in LVAD patients was 80%. One-year survival (1YS) in all patients was 55.0%. 1YS in the CS with MCS group was similar to 1YS in ADHF without CS (p=0.21) (Figure); however, CS patients without temporary MCS had decreased 1YS after adjustment for age, gender, and Charlson Comorbidity score (HR 3.21 for death versus ADHF without CS, 95% CI 2.16-4.76, p<0.0001).
Conclusions: Short and long-term survival in ADHF with CS is poor, but becomes markedly improved with temporary and durable MCS in appropriately selected patients.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Heart Failure and Cardiomyopathies: What Next When All Else Is Failing?
Abstract Category: 14. Heart Failure and Cardiomyopathies: Therapy
Presentation Number: 1248-252
- 2017 American College of Cardiology Foundation