Acute cardiac care & resuscitation

Complexity of coronary artery disease in infarct-related cardiogenic shock and multivessel disease: a substudy of the DanGer Shock trial

EuroInterventionPublished secondary analysis of the DanGer Shock trial

Primary result · 180-day all-cause mortalityResult — go to the resultAdjusted odds ratio 3.12 95% CI 1.17–8.69

Authors' conclusion

Baseline and residual SYNTAX scores independently predicted 180-day mortality. The mAFP effect was not modified by SYNTAX measures. In the isolated left main subgroup, a hypothesis-generating signal towards a clinical benefit with mAFP use was observed.

Study context

Population
Patients with multivessel disease (MVD) and infarct-related cardiogenic shock (CS) in the DanGer Shock trialpatients with MVD of 355 included in DanGer Shock, 211 had an available baseline SYNTAX score, 35 had an isolated left main (LM) culprit lesion
Participants
256 patients
Comparison
Prognostic value of baseline and residual SYNTAX scores and their influence on the effect of microaxial flow pump (mAFP) support
Primary endpoint
180-day all-cause mortality
Follow-up
180 days

Primary result

180-day all-cause mortality

Adjusted odds ratio

3.12

95% CI 1.17–8.69

High baseline SYNTAX vs low and intermediate baseline SYNTAX scores
adjusted OR 3.12 (95% CI 1.17–8.69)

As reported in the abstract

Further findings

OutcomeValuesAdjusted OR (95% CI)
180-day all-cause mortality, isolated LM culprit lesion subgroup · lower odds with mAFP0.17 (0.03–0.99)
OutcomeValuesEstimate
Baseline SYNTAX group distributionlow baseline SYNTAX 26% · intermediate baseline SYNTAX 47% · high baseline SYNTAX 27%
  • Baseline SYNTAX group distribution: of 211 patients with an available baseline SYNTAX score
  • 180-day all-cause mortality, isolated LM culprit lesion subgroup: subgroup: 35 patients with an isolated LM culprit lesion

Residual SYNTAX score by baseline SYNTAX score

A higher baseline SYNTAX score was associated with a higher residual SYNTAX score
P < 0.001

180-day all-cause mortality by residual SYNTAX score

The residual SYNTAX score independently predicted 180-day all-cause mortality

mAFP effect modification by baseline SYNTAX group

The mAFP effect was not modified by the baseline SYNTAX group
P for interaction = 0.31

Original publication

Complexity of coronary artery disease in infarct-related cardiogenic shock and multivessel disease: a substudy of the DanGer Shock trial. EuroIntervention. Published 5 October 2026. doi:10.4244/eij-d-26-00460

Summarised from the published abstract; every number is checked against it

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