Photo Credit: Mohammed Haneefa Nizamudeen
The following is a summary of “Patient Characteristics, Management and Long-term Outcomes of Patients with Cardiogenic Shock at a Large Safety Net Hospital,” published in the January 2025 issue of Cardiology by Hall et al.
Researchers conducted a retrospective study to examine the characteristics, management, and long-term outcomes of patients with cardiogenic shock (CS), particularly those with heart failure-related CS (HF-CS), within a safety-net hospital system serving a socioeconomically disadvantaged population, with a focus on the potential impact of adverse social determinants of health (SDOH).
They analyzed patients with Stage C, D, or E CS at a public safety-net hospital between 2017 and 2023. Management and outcomes were compared between (HF-CS) and myocardial infarction-related cardiogenic shock (AMI-CS). The primary outcome evaluated was survival over a 2-year period.
The results showed 378 patients (median age 57 years, 44% Black, 35% Hispanic, 81% HF-CS, 19% AMI-CS) with 23% receiving mechanical circulatory support, 30-day mortality was lower in patients with HF-CS (16%) compared to AMI-CS (28%; HR 0.50 [95% CI 0.30-0.84], P =0.01). However, from 31 days to 2 years, HF-CS had higher mortality (45% vs 22%, HR 1.94 [1.11-3.38], P =0.02). At long-term follow-up, 53% of survivors were on beta blockers, and 32% received no guideline-directed medical therapies and 18 patients (5%) received a transplant or left ventricular assist device, all from the HF-CS group, with a median follow-up of 2.3 years (range 0.9-4.0 years).
Investigators concluded that in a large safety-net hospital, HF-CS was more prevalent than AMI-CS, exhibiting lower short-term but higher long-term mortality, with limited use of advanced therapies, though favorable survival was observed among those who received them, emphasizing the need to expand access to specialized heart failure care for socially vulnerable patients with CS.
Source: ajconline.org/article/S0002-9149(25)00036-0/abstract
