Acute cardiac care & resuscitationCohort study
Risk, Management, and Outcomes in PCI-Treated Acute Coronary Syndrome With Cardiogenic Shock
- Keio Interhospital Cardiovascular Studies-PCI registry
- consecutive percutaneous coronary intervention (PCI) procedures
- multicenter
Authors' conclusion
Among patients with ACS-CS selected for PCI in a multicenter Japanese registry, management strategies changed substantially over the past decade, particularly regarding MCS utilization. However, no significant temporal improvement in in-hospital mortality was observed, underscoring the persistent clinical challenges of this high-risk PCI-treated population.
Study context
- Population
- Patients undergoing PCI for acute coronary syndrome complicated by cardiogenic shock (ACS-CS), 2009 to 2019cases (3.5%) with ACS-CS among 24,527 consecutive PCI procedures
- Participants
- 870 patients
- Exposure
- Temporal trends across 4 time periods
Main finding
As reported in the abstract
Predicted in-hospital mortality, stable over time
approximately 20%
Predicted bleeding risk, stable over time
approximately 40%
Observational data: associations, not effects.
Further findings
| Outcome | T1 | T2 | T3 | T4 |
|---|---|---|---|---|
| Overall MCS use | 66.5% | Not reported in the abstract | Not reported in the abstract | 56.7% |
- Overall mechanical circulatory support (MCS) use: declined primarily due to reduced intra-aortic balloon pump use
Intra-aortic balloon pump use
- Reduced intra-aortic balloon pump use
- 46.5% to 31.2%
Crude and National Cardiovascular Data Registry risk-adjusted in-hospital mortality · throughout the study period
- Remained persistently high
- approximately 30%
Original publication
Summarised from the published abstract; every number is checked against it