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Cardiogenic Shock: Recent Advances and Future Perspectives
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Cardiogenic Shock: Recent Advances and Future Perspectives

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: closed (25 June 2022) | Viewed by 5897

Special Issue Editor

Prof. Dr. Konstantinos Karatolios

E-Mail Website
Guest Editor
Department of Cardiology, Philipps-University Marburg, Baldinger Str., 35037 Marburg, Germany
Interests: cardiogenic shock; cardiac arrest; interventional cardiology; heart failure; acute cardiac care
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Despite the increased use of evidence-based medicine and interventions, cardiogenic shock (CS) still contributes to unacceptably high hospital mortality rates. Randomized trials that are adequately powered are particularly challenging to conduct in patients with CS and substantial gaps in knowledge still remain. Advances in understanding the pathophysiology of CS, refined risk stratification, new medical treatment options, indication, timing, type and duration of mechanical circulatory support are all important aspects in the management of CS patients in order to improve outcomes.

In this Special Issue we aim to collect manuscripts that focus on:

  • The role of mechanical circulatory support in CS: indication, timing, type and duration;
  • Medical therapies in CS;
  • Risk stratification tools;

Biomarkers and pathways in CS: their potential role in diagnosis, prognosis and therapy.

Dr. Konstantinos Karatolios
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • cardiogenic shock
  • mechanical circulatory support
  • pathophysiology
  • risk stratification
  • acute cardiac care

Published Papers (3 papers)

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Research

12 pages, 528 KiB  
Article
Stent Selection for Primary Angioplasty and Outcomes in the Era of Potent Antiplatelets. Data from the Multicenter Randomized Prague-18 Trial
by Ota Hlinomaz, Zuzana Motovska, Jiri Knot, Roman Miklik, Mahmoud Sabbah, Milan Hromadka, Ivo Varvarovsky, Jaroslav Dusek, Michal Svoboda, Frantisek Tousek, Bohumil Majtan, Stanislav Simek, Marian Branny and Jiří Jarkovský
J. Clin. Med. 2021, 10(21), 5103; https://doi.org/10.3390/jcm10215103 - 30 Oct 2021
Viewed by 1705
Abstract
Drug-eluting stents (DES) are the recommended stents for primary percutaneous coronary intervention (PCI). This study aimed to determine why interventional cardiologists used non-DES and how it influenced patient prognoses. The efficacy and safety outcomes of the different stents were also compared in patients [...] Read more.
Drug-eluting stents (DES) are the recommended stents for primary percutaneous coronary intervention (PCI). This study aimed to determine why interventional cardiologists used non-DES and how it influenced patient prognoses. The efficacy and safety outcomes of the different stents were also compared in patients treated with either prasugrel or ticagrelor. Of the PRAGUE-18 study patients, 749 (67.4%) were treated with DES, 296 (26.6%) with bare-metal stents (BMS), and 66 (5.9%) with bioabsorbable vascular scaffold/stents (BVS) between 2013 and 2016. Cardiogenic shock at presentation, left main coronary artery disease, especially as the culprit lesion, and right coronary artery stenosis were the reasons for selecting a BMS. The incidence of the primary composite net-clinical endpoint (EP) (death, nonfatal myocardial infarction, stroke, serious bleeding, or revascularization) at seven days was 2.5% vs. 6.3% and 3.0% in the DES, vs. with BMS and BVS, respectively (HR 2.7; 95% CI 1.419–5.15, p = 0.002 for BMS vs. DES and 1.25 (0.29–5.39) p = 0.76 for BVS vs. DES). Patients with BMS were at higher risk of death at 30 days (HR 2.20; 95% CI 1.01–4.76; for BMS vs. DES, p = 0.045) and at one year (HR 2.1; 95% CI 1.19–3.69; p = 0.01); they also had a higher composite of cardiac death, reinfarction, and stroke (HR 1.66; 95% CI 1.0–2.74; p = 0.047) at one year. BMS were associated with a significantly higher rate of primary EP whether treated with prasugrel or ticagrelor. In conclusion, patients with the highest initial risk profile were preferably treated with BMS over BVS. BMS were associated with a significantly higher rate of cardiovascular events whether treated with prasugrel or ticagrelor. Full article
(This article belongs to the Special Issue Cardiogenic Shock: Recent Advances and Future Perspectives)
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12 pages, 1378 KiB  
Article
One-Year Outcome of Glycoprotein IIb/IIIa Inhibitor Therapy in Patients with Myocardial Infarction-Related Cardiogenic Shock
by Krzysztof Myrda, Mariusz Gąsior, Dariusz Dudek, Bartłomiej Nawrotek, Jacek Niedziela, Wojciech Wojakowski, Marek Gierlotka, Marek Grygier, Janina Stępińska, Adam Witkowski, Maciej Lesiak and Jacek Legutko
J. Clin. Med. 2021, 10(21), 5059; https://doi.org/10.3390/jcm10215059 - 29 Oct 2021
Cited by 6 | Viewed by 1370
Abstract
Background: We aimed to evaluate the effect of intravenous glycoprotein IIb/IIIa receptor inhibitors (GPIs) on in-hospital survival and mortality during and at the 1-year follow-up in patients undergoing percutaneous coronary intervention (PCI) for myocardial infarction (MI) complicated by cardiogenic shock (CS), who were [...] Read more.
Background: We aimed to evaluate the effect of intravenous glycoprotein IIb/IIIa receptor inhibitors (GPIs) on in-hospital survival and mortality during and at the 1-year follow-up in patients undergoing percutaneous coronary intervention (PCI) for myocardial infarction (MI) complicated by cardiogenic shock (CS), who were included in the Polish Registry of Acute Coronary Syndromes (PL-ACS). Methods: From 2003 to 2019, 466,566 MI patients were included in the PL-ACS registry. A total of 10,193 patients with CS received PCI on admission. Among them, GPIs were used in 3934 patients. Results: The patients treated with GPIs were younger, had lower systolic blood pressure on admission, required inotropes and intra-aortic balloon pump (IABP) support more frequently, and showed a lower efficacy of coronary angioplasty. In both groups, the same rates of in-hospital adverse events were observed. A lower mortality rate was reported in the group treated with GPIs 12 months after admission (54.9% vs. 57.9%, p = 0.002). Therapy with GPI was an independent factor reducing the risk of mortality in the 12-month follow-up. Conclusions: The addition of GPIs to the standard pharmacotherapy combined with PCI in patients with MI and CS on admission reduced the risk of death in the 12-month follow-up period without increasing in-hospital adverse event rates. Full article
(This article belongs to the Special Issue Cardiogenic Shock: Recent Advances and Future Perspectives)
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12 pages, 1040 KiB  
Article
Comparison of Mechanical Support with Impella or Extracorporeal Life Support in Post-Cardiac Arrest Cardiogenic Shock: A Propensity Scoring Matching Analysis
by Styliani Syntila, Georgios Chatzis, Birgit Markus, Holger Ahrens, Christian Waechter, Ulrich Luesebrink, Dimitar Divchev, Harald Schuett, Panagiota-Eleni Tsalouchidou, Andreas Jerrentrup, Mariana Parahuleva, Bernhard Schieffer and Konstantinos Karatolios
J. Clin. Med. 2021, 10(16), 3583; https://doi.org/10.3390/jcm10163583 - 14 Aug 2021
Cited by 5 | Viewed by 1851
Abstract
Our aim was to compare the outcomes of Impella with extracorporeal life support (ECLS) in patients with post-cardiac arrest cardiogenic shock (CS) complicating acute myocardial infarction (AMI). This was a retrospective study of patients resuscitated from out of hospital cardiac arrest (OHCA) with [...] Read more.
Our aim was to compare the outcomes of Impella with extracorporeal life support (ECLS) in patients with post-cardiac arrest cardiogenic shock (CS) complicating acute myocardial infarction (AMI). This was a retrospective study of patients resuscitated from out of hospital cardiac arrest (OHCA) with post-cardiac arrest CS following AMI (May 2015 to May 2020). Patients were supported either with Impella 2.5/CP or ECLS. Outcomes were compared using propensity score-matched analysis to account for differences in baseline characteristics between groups. 159 patients were included (Impella, n = 105; ECLS, n = 54). Hospital and 12-month survival rates were comparable in the Impella and the ECLS groups (p = 0.16 and p = 0.3, respectively). After adjustment for baseline differences, both groups demonstrated comparable hospital and 12-month survival (p = 0.36 and p = 0.64, respectively). Impella patients had a significantly greater left ventricle ejection-fraction (LVEF) improvement at 96 h (p < 0.01 vs. p = 0.44 in ECLS) and significantly fewer device-associated complications than ECLS patients (15.2% versus 35.2%, p < 0.01 for relevant access site bleeding, 7.6% versus 20.4%, p = 0.04 for limb ischemia needing intervention). In subgroup analyses, Impella was associated with better survival in patients with lower-risk features (lactate < 8.6 mmol/L, time from collapse to return of spontaneous circulation < 28 min, vasoactive score < 46 and Horowitz index > 182). In conclusion, the use of Impella 2.5/CP or ECLS in post-cardiac arrest CS after AMI was associated with comparable adjusted hospital and 12-month survival. Impella patients had a greater LVEF improvement than ECLS patients. Device-related access-site complications occurred more frequently in patients with ECLS than Impella support. Full article
(This article belongs to the Special Issue Cardiogenic Shock: Recent Advances and Future Perspectives)
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