Graduate Student University of Toronto Toronto, Ontario, Canada
Disclosure(s):
Nicole L. Fung: No financial relationships to disclose
Background: The profile of cardiogenic shock (CS) etiology has switched from acute myocardial infarction CS (AMI-CS) to acute decompensated heart failure CS (HF-CS) as the most prominent etiology. In this single centre, retrospective study we sought to determine if differences in CS etiology were associated with adverse outcomes.
Methods: Patients admitted to the cardiac intensive care unit (CICU) at the University Health Network (UHN) from January 1st, 2020, to March 30th, 2025, with a diagnosis of CS were included. Patients were subdivided into those with a primary etiology as AMI-CS, whereas the HF-CS were further divided into ischemic cardiomyopathy (ICM), and non-ischemic cardiomyopathy (NICM). Patient-level data were extracted from charts. Statistical analysis was performed using R scripts.
Outcome: 799 patients were included, of which 27.5% were AMI, 24.1% were ICM, and 48.3% were NICM (Table 1). Patients with NICM were younger, and have lowest prevalence of hypertension, dyslipidemia, and diabetes. AMI had the lowest rates of chronic kidney disease and prior HF diagnosis. CICU resource use differed significantly, with greater balloon pump and mechanical ventilation use in AMI-CS group. Admitting sodium levels were significantly lower in the both HF-CS groups, and AMI were more likely to present in SCAI stage E. Comparing the three etiologies, survival to discharge was significantly lower in the AMI group (62.8%, p = 0.028), and pairwise analysis determined that the difference was significant between AMI and NICM groups (p = 0.011).
Conclusion: While NICM patients within the HF-CS group have a unique presentation profile, patients with AMI-CS have higher in-patient mortality. Additionally, the shock etiology impacts the use of CICU resources. Further analysis of CS etiology is needed to determine potential impacts on management and trajectory, highlighting the need for targeted therapies.
