Primary and secondary cardiac conditions in patients with cardiogenic shock

Cardiogenic shock (CS) primary aetiology is reported to change away from acute myocardial infarction (AMI). Also, little is known about other complicating cardiac conditions in CS.

We explored primary CS aetiology as well as complicating additional cardiac conditions and their associtaions with survival in the retrospective Bergen Cardiogenic Shock Observational Study (BeCSOS) among 64 patients with CS admitted to a Norwegian university hospital during 2020-2022.

The BeCSOS was made up of 67.2% men, the median age was 69 years, and the median blood lactate and serum hs cardiac troponin T concentrations were 4.1 mmol/L and 570 ng/L, respectively. In 50.0% of the patients AMI was the main CS aetiology, whereas tachycardia and acute-on-chronic heart failure constituted 12.5% and 10.9%, respectively. In 57.8% there was at least one additional complicating cardiac condition, with valvular disease and tachycardia being the most prevalent (14.1% and 10.9%, respectively). There were numerical, albeit not statistically significant different, higher mortality rates during ICU stay, and after 30 days and 1 year among patients with AMI-CS than those with other primary CS aetiologies. Among patients with as compared to without an additional complicating cardiac condition there was a trend towards lower mortality during ICU stay (27.0% vs. 48.1%; P=0.07) and after 30 days (32.4% vs. 48.1%; P=0.16), although the proportions alive were essentially similar after one year (51.4% vs. 50.0%; P=0.56).

In this study, half of patients with CS had AMI as the primary aetiology. A majority of patients also had at least one additional complicating cardiac condition. There was a trend towards higher mortality in patients with AMI-CS, whereas we could not find any differences in 1-year survival among patients with than without a complicating cardiac condition.

Mortality rates (%) in the BeCSOS