Acute cardiac care & resuscitation
Epidemiology of cardiogenic shock using the Shock Academic Research Consortium (SHARC) consensus definitions
Authors' conclusion
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.
Study context
- Population
- Patients meeting shock criteria in advanced cardiac intensive care unit (CICUs) of the Critical Care Cardiology Trials Network (CCCTN), 2017–23; CS classified by SHARC definitions (post-cardiotomy CS excluded)5,869 with CS
- Participants
- 8,974 patients
- Exposure
- AMI-CS vs de novo HF-CS vs acute-on-chronic HF-CS vs Secondary CS vs Mixed CS
- Outcome
- CS epidemiology by SHARC category
Methodological detailsmultinational, CICU registry (CCCTN)
- Multinational
- CICU registry (CCCTN)
Main finding
As reported in the abstract
- Isolated CS among patients meeting shock criteria
- 65%
- Mixed shock among patients meeting shock criteria
- 17%
- AMI-CS among CS (65% STEMI)
- 27%
- HF-CS among CS (72% acute-on-chronic, 28% de novo)
- 59%
- Secondary CS among CS
- 14%
Observational data: associations, not effects.
Further findings
| Outcome | Values |
|---|---|
| In-hospital mortality | Mixed CS 48% · AMI-CS 41% · De novo HF-CS 31% · Secondary CS 31% · Acute-on-chronic HF-CS 25% |
| Temporary MCS use | AMI-CS 59% |
- In-hospital mortality: P < 0.001
Concomitant cardiac arrest
- Most likely in AMI-CS and de novo HF-CS
- P < 0.001
More severe shock stage (SCAI D or E) at presentation
- Most likely in AMI-CS and mixed CS
- P < 0.001
Temporary mechanical circulatory support (MCS) use
- Highest in AMI-CS
Original publication
Epidemiology of cardiogenic shock using the Shock Academic Research Consortium (SHARC) consensus definitions. Eur Heart J Acute Cardiovasc Care. Published 29 August 2024. doi:10.
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