부산대학교 도서관

Background: Patient outcomes after cardiac arrest (CA) complicated by cardiogenic shock (CS) not related to acute myocardial infarction (non-AMI) remain poorly understood. The aim of our study was to assess differences in outcomes between non-AMI CS related to in-hospital cardiac arrest (IHCA) and out-of-hospital cardiac arrest (OHCA) using a real-world, multi-institutional registry.Methods: The CS Working Group (CSWG) registry is a retrospective dataset of patients hospitalized with CS from 17 clinical sites. A standardized set of data elements were collected between 2016 and 2021. Patients were identified as having either AMI or non-AMI related CS, and non-AMI related CS was further classified by acuity of etiology as acute-on-chronic heart failure (ACHF) and de novo HF. IHCA or OHCA were defined based on location of CA. The outcomes of this analysis were in-hospital mortality, renal replace therapy (RRT) and mechanical ventilation (MV).Results: There were 1767 patients (age 60.3 ± 14.6 years, 72.4% male) with non-AMI CS enrolled, of whom 1371 (77.6%) had ACHF and 349 (19.7%) had de novo HF. There were 152 (8.6%) IHCA and 103 (5.8%) OHCA. Mortality was higher for ACHF and de novo HF patients with IHCA compared with patients without IHCA, and was higher for ACHF patients with OHCA compared with patients without OHCA (Figure 1A-B). Rates of RRT were higher for ACHF and de novo HF patients with IHCA compared with patients without IHCA and was similar between ACHF and de novo HF patients with and without OHCA (Figure 1C-D). Rates of MV were higher for ACHF and de novo HF patients with IHCA or OHCA compared with ACHF and de novo HF patients without IHCA or OHCA (Figures 1E-F).Conclusion: Outcomes are worse among patients with CA, irrespective of HF etiology or whether CA occurs in or out of the hospital. Further investigation is needed to better understand mechanisms contributing to these poor outcomes and to identify therapeutic targets for improvement.