TY – JOUR
T1 – Pulmonary Artery Catheter Use and Risk of In-hospital Death in Heart Failure Cardiogenic Shock
AU – KANWAR, MANREET K.
AU – BLUMER, VANESSA
AU – ZHANG, YIJING
AU – SINHA, SHASHANK S.
AU – GARAN, ARTHUR R.
AU – HERNANDEZ-MONTFORT, JAIME
AU – KHALIF, ADNAN
AU – HICKEY, GAVIN W.
AU – ABRAHAM, JACOB
AU – MAHR, CLAUDIUS
AU – LI, BORUI
AU – SANGAL, PAAVNI
AU – WALEC, KAROL D.
AU – ZAZZALI, PETER
AU – KATARIA, RACHNA
AU – PAHUJA, MOHIT
AU – TON, VAN A.N.K.H.U.E.
AU – HARWANI, NEIL M.
AU – WENCKER, DETLEF
AU – NATHAN, SANDEEP
AU – VOROVICH, ESTHER
AU – HALL, SHELLEY
AU – KHALIFE, WISSAM
AU – LI, S. O.N.G.
AU – SCHWARTZMAN, ANDREW
AU – KIM, J. U.
AU – VISHNEVSKY, OLEG ALEC
AU – TRINQUART, LUDOVIC
AU – BURKHOFF, DANIEL
AU – KAPUR, NAVIN K.
N1 – Publisher Copyright: © 2023 Elsevier Inc.
PY – 2023/9
Y1 – 2023/9
N2 – Background: Pulmonary artery catheters (PACs) are increasingly used to guide management decisions in cardiogenic shock (CS). The goal of this study was to determine if PAC use was associated with a lower risk of in-hospital mortality in CS owing to acute heart failure (HF-CS). Methods and Results: This multicenter, retrospective, observational study included patients with CS hospitalized between 2019 and 2021 at 15 US hospitals participating in the Cardiogenic Shock Working Group registry. The primary end point was in-hospital mortality. Inverse probability of treatment-weighted logistic regression models were used to estimate odds ratios (ORs) and corresponding 95% confidence intervals (CI), accounting for multiple variables at admission. The association between the timing of PAC placement and in-hospital death was also analyzed. A total of 1055 patients with HF-CS were included, of whom 834 (79%) received a PAC during their hospitalization. In-hospital mortality risk for the cohort was 24.7% (n = 261). PAC use was associated with lower adjusted in-hospital mortality risk (22.2% vs 29.8%, OR 0.68, 95% CI 0.50-0.94). Similar associations were found across SCAI stages of shock, both at admission and at maximum SCAI stage during hospitalization. Early PAC use (≤6 hours of admission) was observed in 220 PAC recipients (26%) and associated with a lower adjusted risk of in-hospital mortality compared with delayed (≥48 hours) or no PAC use (17.3% vs 27.7%, OR 0.54, 95% CI 0.37-0.81). Conclusions: This observational study supports PAC use, because it was associated with decreased in-hospital mortality in HF-CS, especially if performed within 6 hours of hospital admission. Condensed Abstract: An observational study from the Cardiogenic Shock Working Group registry of 1055 patients with HF-CS showed that pulmonary artery catheter (PAC) use was associated with a lower adjusted in-hospital mortality risk (22.2% vs 29.8%, odds ratio 0.68, 95% confidence interval 0.50-0.94) compared with outcomes in patients managed without PAC. Early PAC use (≤6 hours of admission) was associated with a lower adjusted risk of in-hospital mortality compared with delayed (≥48 hours) or no PAC use (17.3% vs 27.7%, odds ratio 0.54, 95% confidence interval 0.37-0.81).
AB – Background: Pulmonary artery catheters (PACs) are increasingly used to guide management decisions in cardiogenic shock (CS). The goal of this study was to determine if PAC use was associated with a lower risk of in-hospital mortality in CS owing to acute heart failure (HF-CS). Methods and Results: This multicenter, retrospective, observational study included patients with CS hospitalized between 2019 and 2021 at 15 US hospitals participating in the Cardiogenic Shock Working Group registry. The primary end point was in-hospital mortality. Inverse probability of treatment-weighted logistic regression models were used to estimate odds ratios (ORs) and corresponding 95% confidence intervals (CI), accounting for multiple variables at admission. The association between the timing of PAC placement and in-hospital death was also analyzed. A total of 1055 patients with HF-CS were included, of whom 834 (79%) received a PAC during their hospitalization. In-hospital mortality risk for the cohort was 24.7% (n = 261). PAC use was associated with lower adjusted in-hospital mortality risk (22.2% vs 29.8%, OR 0.68, 95% CI 0.50-0.94). Similar associations were found across SCAI stages of shock, both at admission and at maximum SCAI stage during hospitalization. Early PAC use (≤6 hours of admission) was observed in 220 PAC recipients (26%) and associated with a lower adjusted risk of in-hospital mortality compared with delayed (≥48 hours) or no PAC use (17.3% vs 27.7%, OR 0.54, 95% CI 0.37-0.81). Conclusions: This observational study supports PAC use, because it was associated with decreased in-hospital mortality in HF-CS, especially if performed within 6 hours of hospital admission. Condensed Abstract: An observational study from the Cardiogenic Shock Working Group registry of 1055 patients with HF-CS showed that pulmonary artery catheter (PAC) use was associated with a lower adjusted in-hospital mortality risk (22.2% vs 29.8%, odds ratio 0.68, 95% confidence interval 0.50-0.94) compared with outcomes in patients managed without PAC. Early PAC use (≤6 hours of admission) was associated with a lower adjusted risk of in-hospital mortality compared with delayed (≥48 hours) or no PAC use (17.3% vs 27.7%, odds ratio 0.54, 95% confidence interval 0.37-0.81).
KW – Heart failure cardiogenic shock
KW – PAC timing
KW – mortality
KW – pulmonary artery catheter
UR – https://www.scopus.com/pages/publications/85161033383
UR – https://www.scopus.com/pages/publications/85161033383#tab=citedBy
U2 – 10.1016/j.cardfail.2023.05.001
DO – 10.1016/j.cardfail.2023.05.001
M3 – Article
C2 – 37187230
AN – SCOPUS:85161033383
SN – 1071-9164
VL – 29
SP – 1234
EP – 1244
JO – Journal of Cardiac Failure
JF – Journal of Cardiac Failure
IS – 9
ER –
