Pazdernik Michal, Ostadal Petr, Seiner Jiri, Pudil Jan, Chaloupka Anna, Novak Martin, Lichnerova Eva, Pelouch Radek, Vondrakova Dagmar, Dvorakova Aneta, Foral David, Kovarik Ales, Hnat Tomas, Zohoor Ahmad, Pocarovsky Adam, Hainzova Aneta, Matejka Jan, Sirotek Ondrej, Valerianova Anna, Vojtisek Martin, Precek Jan, Misun Peter, Sramko Marek, Mares Jan, Belohlavek Jan
Department of Cardiology, Institute for Clinical and Experimental Medicine (IKEM), Videnska 1958/9, Prague 140 21, Czechia.
Department of Cardiology, Second Medical School, Charles University, University Hospital Motol, V Uvalu 84/1, Prague 150 06, Czechia.
Eur Heart J Acute Cardiovasc Care. 2025 Jul 3;14(6):359-363. doi: 10.1093/ehjacc/zuaf034.
Only limited epidemiological data exist from national or international prospective multicentre registries covering the whole spectrum of cardiogenic shock (CS) aetiologies.
A national prospective multicentre observational study, CZECH-SHOCK, was conducted in 15 main tertiary care centres in Czechia over a 12 month period from March 2023 to February 2024. A total of 418 patients with a median age of 70 (interquartile range 59-76) years were enrolled. The majority of patients was males (69.6%). A newly developed heart failure was observed in 76.8% patients, and acute myocardial infarction complicated by CS was the most frequent cause of a CS episode (56.7%). Mechanical circulatory support devices were utilized in 28.2% of cases. A 30 day mortality was 39.5%. In a multivariate analysis, six independent factors were associated with a higher 30 day mortality: age [odds ratio (OR) per 10-year increase: 1.78, 95% confidence interval (CI): 1.45-2.19], history of coronary artery disease (OR: 2.38, 95% CI: 1.41-4.30), history of chronic obstructive pulmonary disease (OR: 2.58, 95% CI: 1.27-5.25), Society for Cardiovascular Angiography and Interventions class on admission (OR per one class increase: 1.64, 95% CI: 1.27-2.11), renal replacement therapy during in-hospital stay (OR: 2.46, 95% CI: 1.32-4.59), and new mechanical ventilation after admission (OR: 4.58, 95% CI: 2.50-8.39).
Acute myocardial infarction complicated by CS still represents the most frequent cause of CS episodes. The in-hospital mortality of patients with CS remains high, despite frequent utilization of haemodynamic support and organ replacement therapies.
