Abstract 12289: Cardiogenic Shock: Mortality Among Patients Presenting in Acute Decompensated Heart Failure Not Secondary to Acute Coronary Syndrome Higher Than Among Patients With Acute Coronary Syndrome

• Published in: Circulation (New York, N.Y.) N.Y.), 2018-11, Vol.138 (Suppl_1 Suppl 1), p.A12289-A12289
• Main Authors: Kaeppler, Mark, Pollock, Eks W, Patel, Kadam, Conti, Mary, Tarima, Sergey, Saltzberg, Mitchell, Kim, Soo, Durham, Lucian, Joyce, David L, Mohammed, Asim
• Format: Article
• Language: English
• ISSN: 0009-7322; 1524-4539

IntroductionCardiogenic shock (CS) is a highly fatal condition characterized by cardiac dysfunction leading to inadequate tissue perfusion. Few studies have sought to clarify the rate of mortality among different patient populations hospitalized with CS.HypothesisWe hypothesized that patients presenting with an acute coronary syndrome (ACS) would experience a higher mortality rate compared to patients with progressive congestive heart failure (CHF) for other reasons.MethodsPatients were hospitalized at an academic medical center with an ICD-9/10 discharge diagnosis of CS between 12/2015 and 8/2017. A chart review identified 3 groupsthose presenting with ACS, those without ACS who had undergone cardiothoracic surgery (postsurgical) and those satisfying neither of these conditions (progressive CHF). Mortality was defined as death in the hospital or as discharge to hospice. Baseline demographics, comorbid conditions, vital signs, echocardiographic data, hemodynamic and laboratory values were obtained. Patient characteristics stratified by admission status were compared. Univariate and multivariate logistic regression analyses were performed. All variables reported as significant had a two-sided p-value ≤0.01, unless otherwise stated.Results490 patients were included in this analysis62% were male, 73% were Caucasian and mean age was 63 years. 123 patients presented with ACS, 98 were postsurgical and 269 were included in the progressive CHF group. ACS patients had higher rates of dyslipidemia, elevated Troponin T and higher use of intra-aortic balloon pump. Postsurgical patients had decreased glucose levels and higher use of surgically placed LVADs and ECMO. The mortality rate among the 3 groups was 30.9%, 18.4% and 43.9%, respectively (p