Cohort study
Prevalence and Predictors of Cardiogenic Shock in Intermediate-Risk Pulmonary Embolism
- Registry study (secondary analysis of the FLASH registry)
- prespecified composite shock score
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)
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
| Comparison | OR (95% CI) | |
|---|---|---|
| Score 6 · predictor of normotensive shock | 5.84 (2.00–17.04) | |
| 0.050.21520Odds ratio (log scale) |
- 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. JACC Cardiovasc Interv. Published 24 April 2023. doi:10.1016/j.jcin.2023.02.004
Summarised from the published abstract; every number is checked against it