Temporal trends in incidence, causes, use of mechanical circulatory support and mortality in cardiogenic shock

AIM: The management of cardiogenic shock remains a clinical challenge even in well‐developed healthcare systems, best illustrated by its high mortality despite numerous innovative proposals for management. The aim of this study was to describe temporal trends in incidence, causes, use of mechanical...

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Autores principales: Schrage, Benedikt, Becher, Peter Moritz, Goßling, Alina, Savarese, Gianluigi, Dabboura, Salim, Yan, Isabell, Beer, Benedikt, Söffker, Gerold, Seiffert, Moritz, Kluge, Stefan, Kirchhof, Paulus, Blankenberg, Stefan, Westermann, Dirk
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8006704/
https://www.ncbi.nlm.nih.gov/pubmed/33605565
http://dx.doi.org/10.1002/ehf2.13202
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author Schrage, Benedikt
Becher, Peter Moritz
Goßling, Alina
Savarese, Gianluigi
Dabboura, Salim
Yan, Isabell
Beer, Benedikt
Söffker, Gerold
Seiffert, Moritz
Kluge, Stefan
Kirchhof, Paulus
Blankenberg, Stefan
Westermann, Dirk
author_facet Schrage, Benedikt
Becher, Peter Moritz
Goßling, Alina
Savarese, Gianluigi
Dabboura, Salim
Yan, Isabell
Beer, Benedikt
Söffker, Gerold
Seiffert, Moritz
Kluge, Stefan
Kirchhof, Paulus
Blankenberg, Stefan
Westermann, Dirk
author_sort Schrage, Benedikt
collection PubMed
description AIM: The management of cardiogenic shock remains a clinical challenge even in well‐developed healthcare systems, best illustrated by its high mortality despite numerous innovative proposals for management. The aim of this study was to describe temporal trends in incidence, causes, use of mechanical circulatory support, and mortality in cardiogenic shock in Germany. METHODS AND RESULTS: Data on all cardiogenic shock patients treated in German hospitals between 2005 and 2017 were obtained from the Federal Bureau of Statistics. The data set comprised 441 696 patients with cardiogenic shock, mean age 71 (±13.8) years, 171 383 (39%) female patients. Incidence rates increased from 33.1/100 000 population in 2005 (27 246 cases) to 51.7/100 000 population in 2017 (42 779 cases). Acute myocardial infarction was the most common cause of cardiogenic shock in 2005–07 (43 422 of 82 037 cases, 52.9%), but the proportion of cases caused by it decreased until 2014–17 (73 274 of 165 873 cases, 44.2%). Over time, intra‐aortic balloon pump (2005: 5104; 2017: 973 cases) was used less frequently, whereas use of extracorporeal‐membrane‐oxygenation (2007: 35; 2017: 2414 cases) and percutaneous left ventricular assist devices (2005: 27; 2017: 1323 cases) increased. Mortality remained high at around 60% without relevant temporal trends in patients without acute myocardial infarction and slightly decreased in patients with acute myocardial infarction. CONCLUSIONS: In this large, nation‐wide study, annual incidence of cardiogenic shock was growing, its causes were changing, and mortality was high despite a shift towards use of novel mechanical circulatory support devices. This highlights the need to address the evidence gap in this field, in particular for cardiogenic shock caused by diseases other than acute myocardial infarction.
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spelling pubmed-80067042021-04-01 Temporal trends in incidence, causes, use of mechanical circulatory support and mortality in cardiogenic shock Schrage, Benedikt Becher, Peter Moritz Goßling, Alina Savarese, Gianluigi Dabboura, Salim Yan, Isabell Beer, Benedikt Söffker, Gerold Seiffert, Moritz Kluge, Stefan Kirchhof, Paulus Blankenberg, Stefan Westermann, Dirk ESC Heart Fail Original Research Articles AIM: The management of cardiogenic shock remains a clinical challenge even in well‐developed healthcare systems, best illustrated by its high mortality despite numerous innovative proposals for management. The aim of this study was to describe temporal trends in incidence, causes, use of mechanical circulatory support, and mortality in cardiogenic shock in Germany. METHODS AND RESULTS: Data on all cardiogenic shock patients treated in German hospitals between 2005 and 2017 were obtained from the Federal Bureau of Statistics. The data set comprised 441 696 patients with cardiogenic shock, mean age 71 (±13.8) years, 171 383 (39%) female patients. Incidence rates increased from 33.1/100 000 population in 2005 (27 246 cases) to 51.7/100 000 population in 2017 (42 779 cases). Acute myocardial infarction was the most common cause of cardiogenic shock in 2005–07 (43 422 of 82 037 cases, 52.9%), but the proportion of cases caused by it decreased until 2014–17 (73 274 of 165 873 cases, 44.2%). Over time, intra‐aortic balloon pump (2005: 5104; 2017: 973 cases) was used less frequently, whereas use of extracorporeal‐membrane‐oxygenation (2007: 35; 2017: 2414 cases) and percutaneous left ventricular assist devices (2005: 27; 2017: 1323 cases) increased. Mortality remained high at around 60% without relevant temporal trends in patients without acute myocardial infarction and slightly decreased in patients with acute myocardial infarction. CONCLUSIONS: In this large, nation‐wide study, annual incidence of cardiogenic shock was growing, its causes were changing, and mortality was high despite a shift towards use of novel mechanical circulatory support devices. This highlights the need to address the evidence gap in this field, in particular for cardiogenic shock caused by diseases other than acute myocardial infarction. John Wiley and Sons Inc. 2021-02-19 /pmc/articles/PMC8006704/ /pubmed/33605565 http://dx.doi.org/10.1002/ehf2.13202 Text en © 2021 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Research Articles
Schrage, Benedikt
Becher, Peter Moritz
Goßling, Alina
Savarese, Gianluigi
Dabboura, Salim
Yan, Isabell
Beer, Benedikt
Söffker, Gerold
Seiffert, Moritz
Kluge, Stefan
Kirchhof, Paulus
Blankenberg, Stefan
Westermann, Dirk
Temporal trends in incidence, causes, use of mechanical circulatory support and mortality in cardiogenic shock
title Temporal trends in incidence, causes, use of mechanical circulatory support and mortality in cardiogenic shock
title_full Temporal trends in incidence, causes, use of mechanical circulatory support and mortality in cardiogenic shock
title_fullStr Temporal trends in incidence, causes, use of mechanical circulatory support and mortality in cardiogenic shock
title_full_unstemmed Temporal trends in incidence, causes, use of mechanical circulatory support and mortality in cardiogenic shock
title_short Temporal trends in incidence, causes, use of mechanical circulatory support and mortality in cardiogenic shock
title_sort temporal trends in incidence, causes, use of mechanical circulatory support and mortality in cardiogenic shock
topic Original Research Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8006704/
https://www.ncbi.nlm.nih.gov/pubmed/33605565
http://dx.doi.org/10.1002/ehf2.13202
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