Research Fellow Tecnológico de Monterrey San Pedro Garza Garcia, Nuevo Leon, Mexico
Disclosure(s):
Jahir Rodriguez-Rivera, MD: No financial relationships to disclose
Background: Cardiogenic shock remains highly lethal despite advances in diagnosis and mechanical circulatory support. Standardized protocols and multidisciplinary teams improve outcomes, yet implementation in low- and middle-income countries remains challenging. Our institution established the first dedicated cardiogenic shock program in northeastern Mexico, evaluating early outcomes before and after team implementation.
Methods: We performed a retrospective cohort study at a tertiary academic center analyzing two time periods: the pre-CS team period (January 2021 - July 2022) and the post-CS team period (August 2022 - November 2025). Consecutive adults meeting SCAI criteria for CS were included. We obtained clinical data from the TecSalud Cardiogenic Shock Registry and electronic medical records. The primary endpoint was 30-day all-cause mortality. Continuous variables were reported as mean ± standard deviation or median (range), and categorical variables as counts and percentages. Mortality rates were compared using Fisher's exact test. Statistical analyses were conducted using RStudio (version 4.5.1), with a two-sided p< 0.05 considered statistically significant.
Outcome: A total of 77 patients were included (27 in pre-CS team and 50 in post-CS team). Demographic and clinical characteristics of the post-CS team cohort are summarized in Table 1. Comparable baseline data were not available for the pre-CS team period due to the absence of a structured registry prior to program initiation. Following implementation of the TecSalud Cardiogenic Shock Team, 30-day mortality significantly decreased from 63% in the pre-CS team period to 26% in the post-CS team period (OR 4.84; 95% confidence interval [CI], 1.77-13.21; p=0.0029). Overall, the cumulative mortality since 2021 is 38.9% by late 2025. Figure 1 illustrates the global cumulative 30-day mortality before and after CS-team implementation.
Conclusion: Establishment of a multidisciplinary, protocol-driven CS program in a resource-limited environment was associated with a reduction in short-term mortality. These findings underscore the feasibility and clinical impact of structured CS care pathways in LMICs and support regional efforts aimed at reducing disparities in CS management and survival across Latin America.
