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Characteristics and Outcomes of Patients with Cardiogenic Shock and Clinically Significant Valvular Heart Disease: From the Critical Care Cardiology Trials Network.

Characteristics and Outcomes of Patients with Cardiogenic Shock and Clinically Significant Valvular Heart Disease: From the Critical Care Cardiology Trials Network. Journal of cardiac failure Carnicelli, A. P., Miller, P. E., Berg, D. D., Aliyev, N., Alviar, C. L., Bohula, E. A., Chaudhry, S. P., Chonde, M., Chow, C., Cooper, H. A., Daniels, L. B., Fordyce, C. B., Ghafghazi, S., Goldfarb, M. J., Gorder, K. L., Hamilton, M. M., Keane, R. R., Kontos, M. C., Kusner, J. J., Leibner, E., Loriaux, D. B., Menon, V., Nair, R. M., Newby, L. K., Oduah, M. T., Palazzolo, M. G., Patolia, H., Pierce, J. B., Pierce, M. J., Potter, B. J., Proudfoot, A., Roswell, R. O., Schnell, G., Shaw, J., Sidhu, K., Sinha, S. S., Varshney, A. S., Katz, J. N., Diepen, S. v., Morrow, D. A. 2025

Abstract

Cardiogenic shock (CS) can be complicated by severe valvular heart disease (VHD). We analyzed cardiac intensive care unit (CICU) admissions by VHD status.The Critical Care Cardiology Trials Network is a multicenter network of tertiary CICUs. Centers contributed data from consecutive admissions during 2-month annual snapshots from 2017 to 2023. CS admissions were classified as having CS attributed to VHD, CS with non-causative VHD, or CS without severe VHD. Demographics and therapies were compared. Unadjusted and adjusted odds ratios for in-hospital mortality were calculated. We analyzed 5,242 admissions with CS (4.1% attributed to VHD, 18.8% with non-causative VHD, 77.1% without severe VHD). Mitral regurgitation (32.1%) and aortic stenosis (27.9%) were the most common pathologies in CS attributed to VHD. Admissions with CS attributed to VHD more commonly had LVEF=40% on admission (present in 62.8%, 22.6%, and 15.1%, respectively; p<0.001). Valve intervention was performed in 32.1% of those with CS attributed to VHD. Unadjusted in-hospital mortality in admissions with CS attributed to VHD was 40.0%, compared to 33.4% and 30.3% in the other groups.VHD is the underlying cause of CS in a minority of CICU admissions but is associated with a high in-hospital mortality.

View details for DOI 10.1016/j.cardfail.2025.01.019

View details for PubMedID 39970998