From July 2016 to December 2020, 73 sites participated in the National Cardiogenic Shock Initiative, or NSCI, a single-arm, prospective trial in which all centers agreed to treat patients with acute MI and cardiogenic shock using a standard protocol emphasizing invasive hemodynamic monitoring and rapid initiation of mechanical circulatory support (MCS). In accordance with the protocol, 71% of patients—average age was of 64, 24% female, 67% admitted in shock. 85% on vasopressors or inotropes, 17% with a witnessed out-of-hospital cardiac arrest, 27% with in-hospital cardiac arrest, 9% under active cardiopulmonary resuscitation during MCS implantation, 73% presenting in SCAI stage C/D shock and 27% in stage E, and presenting with an average BP of 77/50, lactate of 4.8 mmol/dL, and cardiac power output of 0.67W—had MCS implanted prior to PCI. Procedural survival, survival to discharge, 30-day survival, and 1-year survival were 99%, 79%, 77%, and 62%, respectively for patients presenting in stage C/D shock and 98%, 49%, 46%, and 32%, respectively for patients in stage E shock.
