Abstract 13053: Characteristics, Outcomes, and Predictors in Cardiovascular Shock Patients in Japan: Results From the Japanese Circulation Society Cardiovascular Shock Registry
Introduction: Despite the advances in the treatment of cardiogenic shock, mortality in these patients remains high. Data on the actual state of cardiovascular shock treatment and outcomes in Japan are scarce. In this study, we aimed to investigate the baseline characteristics and outcomes of patients with cardiovascular shock and identify the predictors of 30-day mortality.
Methods: The Japanese Circulation Society Cardiovascular Shock registry was a prospective, observational, multi-center, cohort study. Between May 2012 and June 2014, a total of 980 patients with cardiovascular shock were enrolled from 82 centers in Japan. The median (interquartile range) age of the enrolled patients was 72 (63, 81) years, and 66% of the patients were male. The primary endpoint was all-cause death at 30 days.
Results: The causes of shock included acute coronary syndrome (50.6%), non-ischemic arrhythmia (15.9%), aortic disease (14.9%), myocarditis (2.2%), cardiomyopathy (3.4%), pulmonary embolism (4.4%), valvular heart disease (1.3%), infective endocarditis (0.5%) and cardiac tamponade (1.4%). The all-cause mortality was 34.3%. On multivariate analysis, systolic blood pressure (odds ratio [OR], 0.986; 95% confidence interval [CI], 0.98-0.99, p<0.001), neurological status (OR, 1.694; 95% CI, 1.47-1.96, p<0.001), estimated glomerular filtration rate (OR, 0.982; 95% CI, 0.97-0.99, p<0.001), non-ischemic arrhythmia (OR, 0.516; 95% CI, 0.32-0.82, p=0.005), aortic disease (OR, 2.155; 95% CI, 1.41-3.30, p<0.001), and myocarditis (OR, 3.803; 95% CI, 1.41-10.23, p=0.008) were independent predictors of all-cause death at 30 days.
Conclusion: Patients with non-ischemic arrhythmia had better prognosis, whereas those with aortic disease and myocarditis had poor prognosis. Blood pressure, neurological status, and renal function were also independent predictors of 30-day mortality.
Author Disclosures: Y. Ueki: None. M. Mohri: None. T. Matoba: None. T. Kadokami: None. S. Suwa: None. T. Yagi: None. H. Takahashi: None. N. Tanaka: None. Y. Hokama: None. R. Fukuhara: None. E. Tachibana: None. N. Yonemoto: None. K. Nagao: None.
- © 2015 by American Heart Association, Inc.