Pulmonary vascular disease & thromboembolism

Prevalence and Predictors of Cardiogenic Shock in Intermediate-Risk Pulmonary Embolism: Insights From the FLASH Registry

JACC Cardiovasc IntervPublished Registry study

Authors' conclusion

Although hemodynamically stable, over one-third of intermediate-risk FLASH patients were in normotensive shock with a depressed cardiac index. A composite shock score effectively further risk stratified these patients. Mechanical thrombectomy improved hemodynamics and functional outcomes at the 30-day follow-up.

Study context

Population
Intermediate-risk pulmonary embolism (PE) patients undergoing mechanical thrombectomy with the FlowTriever System in the FLASH registry
Participants
384 patients
Outcome
Prevalence of normotensive shock (SBP ≥90 mm Hg but cardiac index ≤2.2 L/min/m²)
Methodological detailssecondary analysis of the FLASH registry, prespecified composite shock score
  • Secondary analysis of the FLASH registry
  • Prespecified composite shock score

Main finding

As reported in the abstract

Normotensive shock

Normotensive shock prevalence (131/384)

34.1%

Observational data: associations, not effects.

Further findings

Normotensive shock by composite shock score

OR (95% CI)
Score 6Predictor of normotensive shock5.84 (2.00–17.04)
Normotensive shock by composite shock score — Prevalence with score 0
0%
Normotensive shock by composite shock score — Prevalence with score 6 (highest)
58.3%

On-table hemodynamics post-thrombectomy

Normalization of cardiac index in normotensive shock patients
30.5%
  • Significant on-table improvements in hemodynamics

RV size, function, dyspnea, quality of life · 30-day follow-up

Significantly improved

Original publication

Prevalence and Predictors of Cardiogenic Shock in Intermediate-Risk Pulmonary Embolism: Insights From the FLASH Registry. JACC Cardiovasc Interv. Published 24 April 2023. doi:10.1016/j.jcin.2023.02.004

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