Argentine National Registry of Cardiogenic Shock (ReNa-SHOCK)

221-227

Abstract

Background: Cardiogenic shock is a severe complication of myocardial infarction and constitutes one of the leading causes of death associated with this condition; yet, the information available in our country is limited.

Objective: The aim of this study was to learn the clinical characteristics, treatment strategies and in-hospital outcome of cardiogenic shock in Argentina.

Methods: A prospective, multicenter registry of patients hospitalized with cardiogenic shock in the context of acute coronary syndromes with and without ST-segment elevation was conducted in 64 centers of Argentina between 2013 and 2015.

Results: The cohort consisted of 165 patients with mean age of 66 (58-76.5) years; 65% were men. Seventy-five percent of cases were ST-segment elevation acute coronary syndromes; 8.5% were associated with mechanical complications and 6.7% had right ventricular involvement. Fifty-six percent presented with cardiogenic shock on admission. Ninety five percent of patients required inotropic agents, 78% mechanical ventilation, 44% Swan-Ganz catheter insertion and 37% intra-aortic balloon pump. Eighty-four percent of ST-segment elevation acute coronary syndromes (104/124 patients) were reperfused. Median time from symptom onset to admission was 240 minutes (132-720) and 80% of patients underwent primary percutaneous coronary intervention. Overall in-hospital mortality was 54% without differences between acute coronary syndromes with or without ST-segment elevation and neither were there differences between both syndrome presentations in the incidence of events and use of procedures.

Conclusions: The characteristics of cardiogenic shock in Argentina are similar to those of populations worldwide. Morbidity and mortality are high despite the use of available treatment strategies.