• Something wrong with this record ?

Clinical presentation, shock severity and mortality in patients with de novo versus acute-on-chronic heart failure-related cardiogenic shock

J. Sundermeyer, C. Kellner, BN. Beer, L. Besch, A. Dettling, LF. Bertoldi, S. Blankenberg, J. Dauw, Z. Dindane, D. Eckner, I. Eitel, T. Graf, P. Horn, J. Jozwiak-Nozdrzykowska, P. Kirchhof, S. Kluge, A. Linke, U. Landmesser, P. Luedike, E....

. 2024 ; 26 (2) : 432-444. [pub] 20231123

Language English Country England, Great Britain

Document type Journal Article, Multicenter Study, Observational Study

Persistent link   https://www.medvik.cz/link/bmc24007416

AIMS: Heart failure-related cardiogenic shock (HF-CS) accounts for a significant proportion of CS cases. Whether patients with de novo HF and those with acute-on-chronic HF in CS differ in clinical characteristics and outcome remains unclear. The aim of this study was to evaluate differences in clinical presentation and mortality between patients with de novo and acute-on-chronic HF-CS. METHODS AND RESULTS: In this international observational study, patients with HF-CS from 16 tertiary care centres in five countries were enrolled between 2010 and 2021. To investigate differences in clinical presentation and 30-day mortality, adjusted logistic/Cox regression models were fitted. Patients (n = 1030) with HF-CS were analysed, of whom 486 (47.2%) presented with de novo HF-CS and 544 (52.8%) with acute-on-chronic HF-CS. Traditional markers of CS severity (e.g. blood pressure, heart rate and lactate) as well as use of treatments were comparable between groups. However, patients with acute-on-chronic HF-CS were more likely to have a higher CS severity and also a higher mortality risk, after adjusting for relevant confounders (de novo HF 45.5%, acute-on-chronic HF 55.9%, adjusted hazard ratio 1.38, 95% confidence interval 1.10-1.72, p = 0.005). CONCLUSION: In this large HF-CS cohort, acute-on-chronic HF-CS was associated with more severe CS and higher mortality risk compared to de novo HF-CS, although traditional markers of CS severity and use of treatments were comparable. These findings highlight the vast heterogeneity of patients with HF-CS, emphasize that HF chronicity is a relevant disease modifier in CS, and indicate that future clinical trials should account for this.

Anesthesia and Intensive Care Fondazione Policlinico San Matteo Hospital IRCCS Pavia Italy

Cardio Center Humanitas Clinical and Research Center IRCCS Rozzano Italy

Center for Population Health Innovation University Heart and Vascular Center Hamburg University Medical Center Hamburg Eppendorf Hamburg Germany

Department of Cardiology and Angiology University Heart Center Freiburg Bad Krozingen Freiburg Germany

Department of Cardiology and Vascular Medicine West German Heart and Vascular Center University Hospital Essen Essen Germany

Department of Cardiology AZ Sint Lucas Ghent Belgium

Department of Cardiology Charité Universitätsmedizin Berlin Campus Benjamin Franklin Berlin Germany

Department of Cardiology IKEM Prague Czech Republic

Department of Cardiology Paracelsus Medical University Nürnberg Nürnberg Germany

Department of Cardiology University Heart and Vascular Center Hamburg Hamburg Germany

Department of Cardiothoracic and Vascular Anesthesia and Intensive Care SS Antonio e Biagio e Cesare Arrigo Hospital Alessandria Italy

Department of Cardiothoracic Surgery University Heart and Vascular Center Hamburg Hamburg Germany

Department of Clinical Surgical Diagnostic and Paediatric Sciences University of Pavia Italy

Department of Intensive Care Medicine University Medical Center Hamburg Eppendorf Hamburg Germany

Department of Internal Medicine 1 University Hospital Jena Jena Germany

Department of Internal Medicine 1 University Hospital Würzburg Würzburg Germany

Department of Internal Medicine and Cardiology Heart Center Leipzig at University of Leipzig and Leipzig Heart Science Leipzig Germany

Department of Medicine 1 University Hospital LMU Munich Munich Germany

Department of Perioperative Medicine St Bartholomew's Hospital London

Division of Cardiology Pulmonology and Vascular Medicine Medical Faculty University Duesseldorf Duesseldorf Germany

German Center for Cardiovascular Research Partner site Hamburg Kiel Lübeck Hamburg Germany

Intensive Cardiac Care Unit and De Gasperis Cardio Center Niguarda Hospital Milan Italy

IRCCS S Maria Nascente Fondazione Don Carlo Gnocchi ONLUS Milan Italy

Medizinische Klinik 2 Kliniken Nordoberpfalz AG Weiden Germany

Rigshospitalet and Department of Clinical Medicine University of Copenhagen Copenhagen Copenhagen Denmark

Technische Universität Dresden Heart Centre Dresden University Hospital Department for Internal Medicine and Cardiology Dresden Germany

University Heart Center Lübeck University Hospital Schleswig Holstein Lübeck Germany

References provided by Crossref.org

000      
00000naa a2200000 a 4500
001      
bmc24007416
003      
CZ-PrNML
005      
20240423155935.0
007      
ta
008      
240412s2024 enk f 000 0|eng||
009      
AR
024    7_
$a 10.1002/ejhf.3082 $2 doi
035    __
$a (PubMed)37940139
040    __
$a ABA008 $b cze $d ABA008 $e AACR2
041    0_
$a eng
044    __
$a enk
100    1_
$a Sundermeyer, Jonas $u Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany $u German Center for Cardiovascular Research (DZHK), Partner site Hamburg/Kiel/Lübeck, Hamburg, Germany $1 https://orcid.org/0000000200762211
245    10
$a Clinical presentation, shock severity and mortality in patients with de novo versus acute-on-chronic heart failure-related cardiogenic shock / $c J. Sundermeyer, C. Kellner, BN. Beer, L. Besch, A. Dettling, LF. Bertoldi, S. Blankenberg, J. Dauw, Z. Dindane, D. Eckner, I. Eitel, T. Graf, P. Horn, J. Jozwiak-Nozdrzykowska, P. Kirchhof, S. Kluge, A. Linke, U. Landmesser, P. Luedike, E. Lüsebrink, N. Majunke, N. Mangner, O. Maniuc, S. Möbius Winkler, P. Nordbeck, M. Orban, F. Pappalardo, M. Pauschinger, M. Pazdernik, A. Proudfoot, M. Kelham, T. Rassaf, H. Reichenspurner, C. Scherer, PC. Schulze, RHG. Schwinger, C. Skurk, M. Sramko, G. Tavazzi, H. Thiele, L. Villanova, N. Morici, EB. Winzer, D. Westermann, F. Gustafsson, B. Schrage
520    9_
$a AIMS: Heart failure-related cardiogenic shock (HF-CS) accounts for a significant proportion of CS cases. Whether patients with de novo HF and those with acute-on-chronic HF in CS differ in clinical characteristics and outcome remains unclear. The aim of this study was to evaluate differences in clinical presentation and mortality between patients with de novo and acute-on-chronic HF-CS. METHODS AND RESULTS: In this international observational study, patients with HF-CS from 16 tertiary care centres in five countries were enrolled between 2010 and 2021. To investigate differences in clinical presentation and 30-day mortality, adjusted logistic/Cox regression models were fitted. Patients (n = 1030) with HF-CS were analysed, of whom 486 (47.2%) presented with de novo HF-CS and 544 (52.8%) with acute-on-chronic HF-CS. Traditional markers of CS severity (e.g. blood pressure, heart rate and lactate) as well as use of treatments were comparable between groups. However, patients with acute-on-chronic HF-CS were more likely to have a higher CS severity and also a higher mortality risk, after adjusting for relevant confounders (de novo HF 45.5%, acute-on-chronic HF 55.9%, adjusted hazard ratio 1.38, 95% confidence interval 1.10-1.72, p = 0.005). CONCLUSION: In this large HF-CS cohort, acute-on-chronic HF-CS was associated with more severe CS and higher mortality risk compared to de novo HF-CS, although traditional markers of CS severity and use of treatments were comparable. These findings highlight the vast heterogeneity of patients with HF-CS, emphasize that HF chronicity is a relevant disease modifier in CS, and indicate that future clinical trials should account for this.
650    _2
$a lidé $7 D006801
650    12
$a srdeční selhání $7 D006333
650    _2
$a mortalita v nemocnicích $7 D017052
650    _2
$a prognóza $7 D011379
650    12
$a kardiogenní šok $x etiologie $7 D012770
655    _2
$a časopisecké články $7 D016428
655    _2
$a multicentrická studie $7 D016448
655    _2
$a pozorovací studie $7 D064888
700    1_
$a Kellner, Caroline $u Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany $u Center for Population Health Innovation (POINT), University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
700    1_
$a Beer, Benedikt N $u Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany $u German Center for Cardiovascular Research (DZHK), Partner site Hamburg/Kiel/Lübeck, Hamburg, Germany
700    1_
$a Besch, Lisa $u Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany $u German Center for Cardiovascular Research (DZHK), Partner site Hamburg/Kiel/Lübeck, Hamburg, Germany
700    1_
$a Dettling, Angela $u Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany $u German Center for Cardiovascular Research (DZHK), Partner site Hamburg/Kiel/Lübeck, Hamburg, Germany
700    1_
$a Bertoldi, Letizia Fausta $u Cardio Center, Humanitas Clinical and Research Center, IRCCS, Rozzano, Italy
700    1_
$a Blankenberg, Stefan $u Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany $u German Center for Cardiovascular Research (DZHK), Partner site Hamburg/Kiel/Lübeck, Hamburg, Germany $u Center for Population Health Innovation (POINT), University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
700    1_
$a Dauw, Jeroen $u Department of Cardiology, AZ Sint-Lucas, Ghent, Belgium
700    1_
$a Dindane, Zouhir $u Technische Universität Dresden, Heart Centre Dresden, University Hospital, Department for Internal Medicine and Cardiology, Dresden, Germany
700    1_
$a Eckner, Dennis $u Department of Cardiology, Paracelsus Medical University Nürnberg, Nürnberg, Germany
700    1_
$a Eitel, Ingo $u German Center for Cardiovascular Research (DZHK), Partner site Hamburg/Kiel/Lübeck, Hamburg, Germany $u University Heart Center Lübeck, University Hospital Schleswig-Holstein, Lübeck, Germany
700    1_
$a Graf, Tobias $u German Center for Cardiovascular Research (DZHK), Partner site Hamburg/Kiel/Lübeck, Hamburg, Germany $u University Heart Center Lübeck, University Hospital Schleswig-Holstein, Lübeck, Germany
700    1_
$a Horn, Patrick $u Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Duesseldorf, Duesseldorf, Germany
700    1_
$a Jozwiak-Nozdrzykowska, Joanna $u Department of Internal Medicine and Cardiology, Heart Center Leipzig at University of Leipzig and Leipzig Heart Science, Leipzig, Germany
700    1_
$a Kirchhof, Paulus $u Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany $u German Center for Cardiovascular Research (DZHK), Partner site Hamburg/Kiel/Lübeck, Hamburg, Germany $u Center for Population Health Innovation (POINT), University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
700    1_
$a Kluge, Stefan $u Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
700    1_
$a Linke, Axel $u Technische Universität Dresden, Heart Centre Dresden, University Hospital, Department for Internal Medicine and Cardiology, Dresden, Germany
700    1_
$a Landmesser, Ulf $u Department of Cardiology, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
700    1_
$a Luedike, Peter $u Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center, University Hospital Essen, Essen, Germany
700    1_
$a Lüsebrink, Enzo $u Department of Medicine I, University Hospital, LMU Munich, Munich, Germany
700    1_
$a Majunke, Nicolas $u Department of Internal Medicine and Cardiology, Heart Center Leipzig at University of Leipzig and Leipzig Heart Science, Leipzig, Germany
700    1_
$a Mangner, Norman $u Technische Universität Dresden, Heart Centre Dresden, University Hospital, Department for Internal Medicine and Cardiology, Dresden, Germany
700    1_
$a Maniuc, Octavian $u Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany
700    1_
$a Möbius Winkler, Sven $u Department of Internal Medicine I, University Hospital Jena, Jena, Germany
700    1_
$a Nordbeck, Peter $u Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany
700    1_
$a Orban, Martin $u Department of Medicine I, University Hospital, LMU Munich, Munich, Germany
700    1_
$a Pappalardo, Federico $u Department of Cardiothoracic and Vascular Anesthesia and Intensive Care, SS. Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy
700    1_
$a Pauschinger, Matthias $u Department of Cardiology, Paracelsus Medical University Nürnberg, Nürnberg, Germany
700    1_
$a Pazdernik, Michal $u Department of Cardiology, IKEM, Prague, Czech Republic
700    1_
$a Proudfoot, Alastair $u Department of Perioperative Medicine, St. Bartholomew's Hospital, London
700    1_
$a Kelham, Matthew $u Department of Perioperative Medicine, St. Bartholomew's Hospital, London
700    1_
$a Rassaf, Tienush $u Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center, University Hospital Essen, Essen, Germany
700    1_
$a Reichenspurner, Hermann $u German Center for Cardiovascular Research (DZHK), Partner site Hamburg/Kiel/Lübeck, Hamburg, Germany $u Department of Cardiothoracic Surgery, University Heart and Vascular Center Hamburg, Hamburg, Germany
700    1_
$a Scherer, Clemens $u Department of Medicine I, University Hospital, LMU Munich, Munich, Germany
700    1_
$a Schulze, Paul Christian $u Department of Internal Medicine I, University Hospital Jena, Jena, Germany
700    1_
$a Schwinger, Robert H G $u Medizinische Klinik II, Kliniken Nordoberpfalz AG, Weiden, Germany
700    1_
$a Skurk, Carsten $u Department of Cardiology, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
700    1_
$a Sramko, Marek $u Department of Cardiology, IKEM, Prague, Czech Republic
700    1_
$a Tavazzi, Guido $u Department of Clinical-Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Italy $u Anesthesia and Intensive Care, Fondazione Policlinico San Matteo Hospital IRCCS, Pavia, Italy
700    1_
$a Thiele, Holger $u Department of Internal Medicine and Cardiology, Heart Center Leipzig at University of Leipzig and Leipzig Heart Science, Leipzig, Germany
700    1_
$a Villanova, Luca $u Intensive Cardiac Care Unit and De Gasperis Cardio-Center, Niguarda Hospital, Milan, Italy
700    1_
$a Morici, Nuccia $u IRCCS S. Maria Nascente-Fondazione Don Carlo Gnocchi, ONLUS, Milan, Italy
700    1_
$a Winzer, Ephraim B $u Technische Universität Dresden, Heart Centre Dresden, University Hospital, Department for Internal Medicine and Cardiology, Dresden, Germany
700    1_
$a Westermann, Dirk $u Department of Cardiology and Angiology, University Heart Center Freiburg-Bad Krozingen, Freiburg, Germany
700    1_
$a Gustafsson, Finn $u Rigshospitalet and Department of Clinical Medicine, University of Copenhagen Copenhagen, Copenhagen, Denmark
700    1_
$a Schrage, Benedikt $u Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany $u German Center for Cardiovascular Research (DZHK), Partner site Hamburg/Kiel/Lübeck, Hamburg, Germany
773    0_
$w MED00006634 $t European journal of heart failure $x 1879-0844 $g Roč. 26, č. 2 (2024), s. 432-444
856    41
$u https://pubmed.ncbi.nlm.nih.gov/37940139 $y Pubmed
910    __
$a ABA008 $b sig $c sign $y - $z 0
990    __
$a 20240412 $b ABA008
991    __
$a 20240423155931 $b ABA008
999    __
$a ok $b bmc $g 2081411 $s 1217183
BAS    __
$a 3
BAS    __
$a PreBMC-MEDLINE
BMC    __
$a 2024 $b 26 $c 2 $d 432-444 $e 20231123 $i 1879-0844 $m European journal of heart failure $n Eur J Heart Fail $x MED00006634
LZP    __
$a Pubmed-20240412

Find record

Citation metrics

Archiving options