PMID- 37294681
OWN - NLM
STAT- MEDLINE
DCOM- 20230710
LR  - 20230718
IS  - 2048-8734 (Electronic)
IS  - 2048-8726 (Linking)
VI  - 12
IP  - 7
DP  - 2023 Jul 7
TI  - Impact of annual volume of cases and intensive cardiac care unit availability on 
      mortality of patients with acute myocardial infarction-related cardiogenic shock 
      treated at revascularization capable centres.
PG  - 422-429
LID - 10.1093/ehjacc/zuad061 [doi]
AB  - AIMS: Cardiogenic shock (CS) is associated with high mortality. The purpose of 
      this study was to assess the impact of hospital structure-related variables on 
      mortality in patients with CS treated at percutaneous and surgical 
      revascularization capable centres (psRCC) from a large nationwide registry. 
      METHODS AND RESULTS: Retrospective observational study including consecutive 
      patients with main or secondary diagnosis of CS and ST elevation myocardial 
      infarction (STEMI). Patients discharged from Spanish National Healthcare System 
      psRCC were included (2016-20). The association between the volume of CS cases 
      attended by each centre, availability of intensive cardiac care unit (ICCU) and 
      heart transplantation (HT) programmes, and in-hospital mortality was assessed by 
      multilevel logistic regression models. The study population consisted of 3074 
      CS-STEMI episodes, of whom 1759 (57.2%) occurred in 26 centres with ICCU. A total 
      of 17/44 hospitals (38.6%) were high-volume centres, and 19/44 (43%) centres had 
      HT programmes availability. Treatment at HT centres was not associated with a 
      lower mortality (P = 0.121). Both high volume of cases and ICCU showed a trend to 
      an association with lower mortality in the adjusted model [odds ratio (OR): 0.87 
      and 0.88, respectively]. The interaction between both variables was significantly 
      protective (OR 0.72; P = 0.024). After propensity score matching, mortality was 
      lower in high-volume hospitals with ICCU (OR 0.79; P = 0.007). CONCLUSION: Most 
      CS-STEMI patients were attended at psRCC with high volume of cases and ICCU 
      available. The combination of high volume and ICCU availability showed the lowest 
      mortality. These data should be taken into account when designing regional 
      networks for CS management.
CI  - (c) The Author(s) 2023. Published by Oxford University Press on behalf of the 
      European Society of Cardiology. All rights reserved. For permissions, please 
      e-mail: journals.permissions@oup.com.
FAU - Barrionuevo-Sanchez, M Isabel
AU  - Barrionuevo-Sanchez MI
AD  - Bellvitge University Hospital, L'Hospitalet de Llobregat, Feixa Llarga s/n, 08907 
      Barcelona, Spain.
AD  - Bioheart, Grup de Malalties Cardiovasculars, Institut d'Investigacio Biomedica de 
      Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Feixa Llarga s/n, 08907 Barcelona, 
      Spain.
FAU - Viana-Tejedor, Ana
AU  - Viana-Tejedor A
AUID- ORCID: 0000-0002-7194-8419
AD  - Hospital Clinico San Carlos, Prof Martin Lagos Street, 28040 Madrid, Spain.
FAU - Ariza-Sole, Albert
AU  - Ariza-Sole A
AUID- ORCID: 0000-0002-0819-6656
AD  - Bellvitge University Hospital, L'Hospitalet de Llobregat, Feixa Llarga s/n, 08907 
      Barcelona, Spain.
AD  - Bioheart, Grup de Malalties Cardiovasculars, Institut d'Investigacio Biomedica de 
      Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Feixa Llarga s/n, 08907 Barcelona, 
      Spain.
FAU - Del Prado, Nayade
AU  - Del Prado N
AD  - Fundacion Instituto para la Mejora de la Asistencia Sanitaria, Beatriz de 
      Bobadilla street 13, Bj, 28008 Madrid, Spain.
FAU - Rosillo, Nicolas
AU  - Rosillo N
AD  - Fundacion Instituto para la Mejora de la Asistencia Sanitaria, Beatriz de 
      Bobadilla street 13, Bj, 28008 Madrid, Spain.
AD  - Hospital Universitario 12 de Octubre, Cordoba Avenue, 28041 Madrid, Spain.
FAU - Sanchez-Salado, Jose Carlos
AU  - Sanchez-Salado JC
AD  - Bellvitge University Hospital, L'Hospitalet de Llobregat, Feixa Llarga s/n, 08907 
      Barcelona, Spain.
AD  - Bioheart, Grup de Malalties Cardiovasculars, Institut d'Investigacio Biomedica de 
      Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Feixa Llarga s/n, 08907 Barcelona, 
      Spain.
FAU - Lorente, Victoria
AU  - Lorente V
AD  - Bellvitge University Hospital, L'Hospitalet de Llobregat, Feixa Llarga s/n, 08907 
      Barcelona, Spain.
AD  - Bioheart, Grup de Malalties Cardiovasculars, Institut d'Investigacio Biomedica de 
      Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Feixa Llarga s/n, 08907 Barcelona, 
      Spain.
FAU - Jorge-Perez, Pablo
AU  - Jorge-Perez P
AD  - Cardiology Department, Hospital Universitario de Canarias, Carretera Ofra, La 
      Laguna, 38320 Santa Cruz de Tenerife, Spain.
FAU - Noriega, Francisco Javier
AU  - Noriega FJ
AD  - Hospital Clinico San Carlos, Prof Martin Lagos Street, 28040 Madrid, Spain.
FAU - Ferrera, Carlos
AU  - Ferrera C
AD  - Hospital Clinico San Carlos, Prof Martin Lagos Street, 28040 Madrid, Spain.
FAU - Alegre, Oriol
AU  - Alegre O
AD  - Bellvitge University Hospital, L'Hospitalet de Llobregat, Feixa Llarga s/n, 08907 
      Barcelona, Spain.
AD  - Bioheart, Grup de Malalties Cardiovasculars, Institut d'Investigacio Biomedica de 
      Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Feixa Llarga s/n, 08907 Barcelona, 
      Spain.
FAU - Llao, Isaac
AU  - Llao I
AD  - Bellvitge University Hospital, L'Hospitalet de Llobregat, Feixa Llarga s/n, 08907 
      Barcelona, Spain.
AD  - Bioheart, Grup de Malalties Cardiovasculars, Institut d'Investigacio Biomedica de 
      Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Feixa Llarga s/n, 08907 Barcelona, 
      Spain.
FAU - Bernal, Jose Luis
AU  - Bernal JL
AD  - Fundacion Instituto para la Mejora de la Asistencia Sanitaria, Beatriz de 
      Bobadilla street 13, Bj, 28008 Madrid, Spain.
AD  - Hospital Universitario 12 de Octubre, Cordoba Avenue, 28041 Madrid, Spain.
FAU - Triguero, Laura
AU  - Triguero L
AD  - Bellvitge University Hospital, L'Hospitalet de Llobregat, Feixa Llarga s/n, 08907 
      Barcelona, Spain.
AD  - Bioheart, Grup de Malalties Cardiovasculars, Institut d'Investigacio Biomedica de 
      Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Feixa Llarga s/n, 08907 Barcelona, 
      Spain.
FAU - Fernandez-Perez, Cristina
AU  - Fernandez-Perez C
AD  - Fundacion Instituto para la Mejora de la Asistencia Sanitaria, Beatriz de 
      Bobadilla street 13, Bj, 28008 Madrid, Spain.
AD  - Servicio de Medicina Preventiva, Area Sanitaria de Santiago y Barbanza, Instituto 
      de Investigaciones Sanitarias de Santiago, Tr Da Choupama, 15706 Santiago de 
      Compostela (A Coruna), Spain.
FAU - Gonzalez-Costello, Jose
AU  - Gonzalez-Costello J
AD  - Bellvitge University Hospital, L'Hospitalet de Llobregat, Feixa Llarga s/n, 08907 
      Barcelona, Spain.
AD  - Bioheart, Grup de Malalties Cardiovasculars, Institut d'Investigacio Biomedica de 
      Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Feixa Llarga s/n, 08907 Barcelona, 
      Spain.
AD  - Centro de Investigacion Biomedica en Red Enfermedades Cardiovasculares CIBER-CV, 
      Instituto de Salud Carlos III, Melchor Fernandez Almagro Stret, 3, 28029 Madrid, 
      Spain.
FAU - Marcos, Marta
AU  - Marcos M
AD  - Bellvitge University Hospital, L'Hospitalet de Llobregat, Feixa Llarga s/n, 08907 
      Barcelona, Spain.
AD  - Bioheart, Grup de Malalties Cardiovasculars, Institut d'Investigacio Biomedica de 
      Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Feixa Llarga s/n, 08907 Barcelona, 
      Spain.
FAU - de la Cuerda, Francisco
AU  - de la Cuerda F
AD  - Bellvitge University Hospital, L'Hospitalet de Llobregat, Feixa Llarga s/n, 08907 
      Barcelona, Spain.
AD  - Bioheart, Grup de Malalties Cardiovasculars, Institut d'Investigacio Biomedica de 
      Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Feixa Llarga s/n, 08907 Barcelona, 
      Spain.
FAU - Carmona, Jesus
AU  - Carmona J
AD  - Bellvitge University Hospital, L'Hospitalet de Llobregat, Feixa Llarga s/n, 08907 
      Barcelona, Spain.
AD  - Bioheart, Grup de Malalties Cardiovasculars, Institut d'Investigacio Biomedica de 
      Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Feixa Llarga s/n, 08907 Barcelona, 
      Spain.
FAU - Cequier, Angel
AU  - Cequier A
AD  - Bellvitge University Hospital, L'Hospitalet de Llobregat, Feixa Llarga s/n, 08907 
      Barcelona, Spain.
FAU - Fernandez-Ortiz, Antonio
AU  - Fernandez-Ortiz A
AD  - Hospital Clinico San Carlos, Prof Martin Lagos Street, 28040 Madrid, Spain.
FAU - Perez-Villacastin, Julian
AU  - Perez-Villacastin J
AD  - Hospital Clinico San Carlos, Prof Martin Lagos Street, 28040 Madrid, Spain.
FAU - Comin-Colet, Josep
AU  - Comin-Colet J
AUID- ORCID: 0000-0001-8780-720X
AD  - Bellvitge University Hospital, L'Hospitalet de Llobregat, Feixa Llarga s/n, 08907 
      Barcelona, Spain.
AD  - Bioheart, Grup de Malalties Cardiovasculars, Institut d'Investigacio Biomedica de 
      Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Feixa Llarga s/n, 08907 Barcelona, 
      Spain.
AD  - Centro de Investigacion Biomedica en Red Enfermedades Cardiovasculares CIBER-CV, 
      Instituto de Salud Carlos III, Melchor Fernandez Almagro Stret, 3, 28029 Madrid, 
      Spain.
FAU - Elola, Francisco Javier
AU  - Elola FJ
AD  - Fundacion Instituto para la Mejora de la Asistencia Sanitaria, Beatriz de 
      Bobadilla street 13, Bj, 28008 Madrid, Spain.
LA  - eng
GR  - Spanish Society of Cardiology/
GR  - Instituto para la Mejoria de la Atencion Sanitaria/
PT  - Journal Article
PT  - Observational Study
PL  - England
TA  - Eur Heart J Acute Cardiovasc Care
JT  - European heart journal. Acute cardiovascular care
JID - 101591369
SB  - IM
MH  - Humans
MH  - Shock, Cardiogenic/etiology/therapy/diagnosis
MH  - *ST Elevation Myocardial Infarction/complications/surgery/diagnosis
MH  - *Myocardial Infarction/complications/surgery
MH  - Intensive Care Units
MH  - Retrospective Studies
MH  - Hospital Mortality
MH  - *Percutaneous Coronary Intervention/adverse effects
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Cardiogenic shock
OT  - Cardiogenic shock networks
OT  - Intensive cardiac care unit
OT  - Volume of cases
COIS- Conflict of interest: None declared.
EDAT- 2023/06/09 19:42
MHDA- 2023/07/10 06:42
CRDT- 2023/06/09 13:03
PHST- 2023/03/10 00:00 [received]
PHST- 2023/05/02 00:00 [revised]
PHST- 2023/06/07 00:00 [accepted]
PHST- 2023/07/10 06:42 [medline]
PHST- 2023/06/09 19:42 [pubmed]
PHST- 2023/06/09 13:03 [entrez]
AID - 7192937 [pii]
AID - 10.1093/ehjacc/zuad061 [doi]
PST - ppublish
SO  - Eur Heart J Acute Cardiovasc Care. 2023 Jul 7;12(7):422-429. doi: 
      10.1093/ehjacc/zuad061.