Acute cardiac care & resuscitationSecondary analysis
Treating Older Patients in Cardiogenic Shock With a Microaxial Flow Pump
- Secondary analysis of the DanGer Shock randomised trial
- international
- multicentre
- open-label
- exploratory
Authors' conclusion
This exploratory secondary analysis of the DanGer Shock trial demonstrates that older patients with STEMI-related CS experience high mortality and may not attain the same benefit from routine treatment with an mAFP as younger patients.
Study context
- Population
- Adults with STEMI-related cardiogenic shock
- Participants
- 355 adults
- Comparison
- Microaxial flow pump (mAFP) plus standard care vs standard care alone, by age
- Primary endpoint
- All-cause mortality, analysed by age and intervention
- Follow-up
- 180 days
Primary result
As reported in the abstract
180-day mortality by age (<77 vs ≥77 years)
mAFP vs Standard careOdds ratio (95% CI)P value
age <77 years
0.45(0.28–0.73)
P = 0.001age ≥77 years
1.52(0.57–4.08)
P = 0.40- Predicted mortality risk higher with standard care until ~77 years, then higher with mAFP
- P = 0.20
Further findings
| Outcome | adjusted OR (95% CI) | P value | |
|---|---|---|---|
| 180-day mortality by age quartile (lowest to highest) | 7.85 (3.37–19.2) | P < 0.001 | |
| 0.050.21520Adjusted odds ratio (log scale) |
- 180-day mortality by age quartile (lowest to highest) — Mortality by quartile: 31%, 47%, 61%, 73%
- log-rank P < 0.001
Safety
Complications
- More frequent with mAFP; no apparent differences in incidence across ages
Original publication
Treating Older Patients in Cardiogenic Shock With a Microaxial Flow Pump. J Am Coll Cardiol. Published 15 November 2024. doi:10.1016/j.jacc.2024.11.003
Summarised from the published abstract; every number is checked against it