Differences Between Ischemic and Non-Ischemic Cardiomyopathy in Heart Failure Related Cardiogenic Shock.
Publication/Presentation Date
2-26-2025
Abstract
BACKGROUND: Heart failure-related cardiogenic shock (HF-CS) accounts for a growing proportion of cardiogenic shock (CS) related admissions to contemporary cardiac intensive care units. Limited data exists comparing non-ischemic (NICM) and ischemic cardiomyopathies (ICM) in this setting.
METHODS AND RESULTS: We sought to examine the differences in patient characteristics, in-hospital treatments, and outcomes among individuals admitted with ICM and NICM HF-CS. The study population included CS admissions within the Critical Care Cardiology Trials Network registry from 2017 to 2022. CS due to acute myocardial infarction or secondary causes was excluded. Admission characteristics, in-hospital treatments, and outcomes were captured. The primary outcome of all-cause in-hospital mortality for ICM versus NICM was compared using multivariable logistic regression. 2,463 hospital admissions for HF-CS including 902 (36.6%) admissions with ICM and 1561 (63.4%) admissions with NICM were included. Patients with ICM more frequently had pre-existing comorbidities, pre-admission cardiac arrest, and higher Sequential Organ Failure Assessment scores. Use of inotropes and temporary mechanical circulatory support were similar; however, the rates of mechanical ventilation and renal replacement therapies were higher for ICM. Patients with ICM were less likely to undergo cardiac transplantation, but had similar rates of durable left ventricular assist device implantation. After multivariable adjustment, patients with ICM were significantly more likely to die during the index hospitalization (OR 1.56, 95% CI 1.26-1.93; p <0.001).
CONCLUSIONS: Among patients admitted to CICUs with HF-CS, patients with ICM were sicker, less likely to undergo cardiac transplantation, and more likely to die when compared with patients with NICM.
ISSN
1532-8414
Published In/Presented At
Feinman, J., Tomey, M. I., Palazzolo, M. G., Martillo, M., Ronquillo, M., Moss, N., Serrao, G., Bohula, E. A., Berg, D. D., van Diepen, S., Katz, J. N., Chonde, M. D., Chaudhry, S. P., George, A. J., Gerber, D., Goldfarb, M. J., Keller, N. M., Kontos, M. C., Loriaux, D. B., O'Brien, C. G., … Leibner, E. (2025). Differences Between Ischemic and Non-Ischemic Cardiomyopathy in Heart Failure Related Cardiogenic Shock. Journal of cardiac failure, S1071-9164(25)00088-0. Advance online publication. https://doi.org/10.1016/j.cardfail.2025.01.020
Disciplines
Medicine and Health Sciences
PubMedID
40021044
Department(s)
Department of Medicine, Cardiology Division, Fellows and Residents
Document Type
Article
