Epidemiology of Cardiogenic Shock Using the Shock Academic Research Consortium (SHARC) Consensus Definitions.
Publication/Presentation Date
8-29-2024
Abstract
BACKGROUND: The Shock Academic Research Consortium (SHARC) recently proposed pragmatic consensus definitions to standardize classification of cardiogenic shock (CS) in registries and clinical trials. We aimed to describe contemporary CS epidemiology using the SHARC definitions in a cardiac intensive care unit (CICU) population.
METHODS: The Critical Care Cardiology Trials Network (CCCTN) is a multinational research network of advanced CICUs coordinated by the TIMI Study Group (Boston, MA). CS was defined as a cardiac disorder resulting in SBP≥30 minutes (or the need for vasopressors, inotropes, or mechanical circulatory support [MCS] to maintain SBP ≥90mmHg) with evidence of hypoperfusion. Primary etiologic categories included acute myocardial infarction-related CS (AMI-CS), heart failure-related CS (HF-CS), and non-myocardial (secondary) CS. Post-cardiotomy CS was not included. HF-CS was further subcategorized as de novo vs. acute-on-chronic HF-CS. Patients with both cardiogenic and non-cardiogenic components of shock were classified separately as mixed CS.
RESULTS: Of 8,974 patients meeting shock criteria (2017-2023), 65% had isolated CS and 17% had mixed shock. Among patients with CS (n=5,869), 27% had AMI-CS (65% STEMI), 59% HF-CS (72% acute-on-chronic, 28% de novo), and 14% secondary CS. Patients with AMI-CS and de novo HF-CS were most likely to have had concomitant cardiac arrest (p
CONCLUSIONS: SHARC consensus definitions for CS classification can be pragmatically applied in contemporary registries and reveal discrete subpopulations of CS with distinct phenotypes and outcomes that may be relevant to clinical practice and future research.
ISSN
2048-8734
Published In/Presented At
Berg, D. D., Bohula, E. A., Patel, S. M., Alfonso, C. E., Alviar, C. L., Baird-Zars, V. M., Barnett, C. F., Barsness, G. W., Bennett, C. E., Chaudhry, S. P., Fordyce, C. B., Ghafghazi, S., Gidwani, U. K., Goldfarb, M. J., Katz, J. N., Menon, V., Miller, P. E., Newby, L. K., Papolos, A. I., Park, J. G., … Morrow, D. A. (2024). Epidemiology of Cardiogenic Shock Using the Shock Academic Research Consortium (SHARC) Consensus Definitions. European heart journal. Acute cardiovascular care, zuae098. Advance online publication. https://doi.org/10.1093/ehjacc/zuae098
Disciplines
Medicine and Health Sciences
PubMedID
39208447
Department(s)
Department of Medicine, Cardiology Division
Document Type
Article