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Classic versus normotensive cardiogenic shock: a single center comparison analysis
Session:
SESSÃO DE POSTERS 35 - DOENÇAS CARDIOVASCULARES - CHOQUE CARDIOGÉNICO 1
Speaker:
Marta Catarina Almeida
Congress:
CPC 2025
Topic:
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme:
14. Acute Cardiac Care
Subtheme:
14.4 Acute Cardiac Care – Cardiogenic Shock
Session Type:
Cartazes
FP Number:
---
Authors:
Marta Catarina Almeida; André Lobo; Catarina Pohle; Jéni Quintal; Marta Leite; Inês Neves; Adelaide Dias; Daniel Caeiro; Marisa Silva; Marta Ponte; Pedro Teixeira; Ricardo Fontes-Carvalho
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-family:"Arial",sans-serif">Background:</span></strong><span style="font-family:"Arial",sans-serif"> In cardiogenic shock (CS), severe impairment in cardiac output results in organ hypoperfusion. In normotensive shock, this occurs with blood pressure still equal to or above 90mmHg. </span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-family:"Arial",sans-serif">Purpose: </span></strong><span style="font-family:"Arial",sans-serif">The aim of the study was to compare classic with normotensive CS, namely critical care support used and mortality.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-family:"Arial",sans-serif">Methods:</span></strong><span style="font-family:"Arial",sans-serif"> Retrospective data of 175 CS patients admitted to an intensive cardiac unit for 5 years was analyzed. Patients in cardiac arrest at admission were excluded (n=34). Comorbidities, diagnosis, left ventricular ejection fraction (LVEF) and analytic data at admission, SCAI classification, critical care support and mortality at 30 days and 1 year were registered. Chi-square and Mann-Whitney tests were used to compare patients with classic and normotensive CS.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-family:"Arial",sans-serif">Results:</span></strong><span style="font-family:"Arial",sans-serif"> This study included 141 patients, 36 (25.5%) with classic and 105 (74.5%) with normotensive CS, as characterized in table 1. Median blood pressure in patients with classic CS was 80 [10] mmHg and 112 [36] mmHg in patients with normotensive CS. There were no differences regarding comorbidities, diagnosis or LVEF at admission. SCAI classification was different between groups (p 0.017), with no patients in stage A and almost half of the patients in stage C (16 patients, 44%) in classic CS and a wider distribution in patients with normotensive CS [14 patients (13.3%) in stage A, 23 (21.9%) in stage B, 33 (31.4%) in stage C, 26 (24.8%) in stage D and 9 (8.6%) in stage E]. Only creatinine was significantly different between patients with classic and normotensive CS [1.5 [1.7] vs 1.2 [0.9] mg/dL, p 0.025]. Lactate levels were higher in classic CS but without statistically significant differences (3.2 [6] vs 2.3 [3] U/L, p 0.060). There were no statistically significant differences regarding critical care support use, although noradrenaline use was higher in patients with classic CS [33 (92%) vs 79 (75%), p 0.054]. Mechanical circulatory support, mechanical ventilation and renal replacement therapy were used similarly in classic and normotensive CS. Mortality outcomes at 30 days and 1 year were similar between groups.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-family:"Arial",sans-serif">Conclusion: </span></strong><span style="font-family:"Arial",sans-serif">Only SCAI classification and creatinine levels were significantly different between patients with classic and normotensive CS. No differences regarding critical care support were verified and mortality in classic and normotensive CS were similar, enhancing the importance of recognition and adequate support of CS even when there is no hypotension at presentation.</span></span></span></p>
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