Acute cardiac care & resuscitationCohort study
Clinical Course of Patients in Cardiogenic Shock Stratified by Phenotype
- Retrospective cohort study
- registry
- external validation of machine learning-based phenotypes
Authors' conclusion
The findings support the universal applicability of these phenotypes using supervised machine learning.
Study context
- Population
- All-cause cardiogenic shock patients, CSWG registry version 2phenotyped in 796
- Participants
- 1,890 patients
- Exposure
- Cardiogenic shock (CS) phenotypes I, II and III
Main finding
As reported in the abstract
In-hospital mortality
- Comparable to initially reported V1 rates (I, II, III)
- 21%, 45%, and 55%
- Admission phenotypes II and III and SCAI stage E independently associated with increased mortality vs noncongested stage C CS (multivariable logistic regression)
- P < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | Values | OR (95% CI) | P value | |
|---|---|---|---|---|
| In-hospital mortality with vs without mechanical circulatory support, by phenotype — Receiving mechanical circulatory support vs I · cardiorenal | 1.82 (1.16–2.84) | P = 0.008 | ||
| In-hospital mortality with vs without mechanical circulatory support, by phenotype — Receiving mechanical circulatory support vs I · noncongested | 1.26 (0.64–2.47) | P = 0.51 | ||
| In-hospital mortality with vs without mechanical circulatory support, by phenotype — Receiving mechanical circulatory support vs I · cardiometabolic | 1.39 (0.86–2.25) | P = 0.18 | ||
| 0.20.5125Odds ratio (log scale) |
| Outcome | Values | Estimate | P value |
|---|---|---|---|
| Mechanical circulatory support received, by phenotype | Phenotype I 58.8% |
- Mechanical circulatory support received, by phenotype: P = 0.013
Independent predictors of mortality (multivariable logistic regression)
- Admission phenotypes II and III and SCAI stage E independently associated with increased mortality vs noncongested "stage C" CS
- P < 0.001
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Clinical Course of Patients in Cardiogenic Shock Stratified by Phenotype. JACC Heart Fail. Published 21 June 2023. doi:10.1016/j.jchf.2023.05.007
Summarised from the published abstract; every number is checked against it