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Clinical characteristics and prognostic factors in acute coronary syndrome patients complicated with cardiogenic shock in Japan: analysis from the Japanese Circulation Society Cardiovascular Shock Registry

  • Kazuo Sakamoto
  • Tetsuya MatobaEmail author
  • Masahiro Mohri
  • Yasushi Ueki
  • Yasuyuki Tsujita
  • Masao Yamasaki
  • Nobuhiro Tanaka
  • Yohei Hokama
  • Motoki Fukutomi
  • Katsutaka Hashiba
  • Rei Fukuhara
  • Satoru Suwa
  • Hirohide Matsuura
  • Eizo Tachibana
  • Naohiro Yonemoto
  • Ken Nagao
Original Article
  • 22 Downloads

Abstract

Cardiogenic shock frequently leads to death even with intensive treatment. Although the leading cause of cardiogenic shock is acute coronary syndrome (ACS), the clinical characteristics and the prognosis of ACS with cardiogenic shock in the present era still remain to be elucidated. We analyzed clinical characteristics and predictors of 30-day mortality in ACS with cardiogenic shock in Japan. The Japanese Circulation Society Cardiovascular Shock registry was a prospective, observational, multicenter, cohort study. Between May 2012 and June 2014, 495 ACS patients with cardiogenic shock were analyzed. The primary endpoint was 30-day all-cause mortality. The median [interquartile range; IQR] age was 71.0 [63.0, 80.0] years. The median [IQR] value of systolic blood pressure (SBP) and heart rate were 75.0 [50.0, 86.5] mm Hg and 65.0 [38.0, 98.0] bpm, respectively. Multivariable analysis showed an odds ratio (OR) of 4.76 (confidence intervals; CI 1.97–11.5, p < 0.001) in the lowest SBP category (< 50 mm Hg) for SBP ≥ 90 mm Hg. Moreover, age per 10 years increase (OR 1.38, CI 1.18–1.61, p = 0.002), deep coma (OR 3.49, CI 1.94–6.34, p < 0.001), congestive heart failure (OR 3.81, CI 2.04–7.59, p < 0.001) and left main trunk disease (LMTD) (OR 2.81, CI 1.55–5.10, p < 0.001) were independent predictors. Severe hypotension, older age, deep coma, congestive heart failure, and LMTD were independent unfavorable factors in ACS complicated by cardiogenic shock in Japan. A prompt assessment of high-risk patients referring to those predictors in emergency room could lead to appropriate treatment without delay.

Keywords

Acute coronary syndrome Cardiogenic shock Mortality Prognostic factors 

Notes

Acknowledgements

Conception and design: TM, MM, YU, YT, MY, ET, NY, KN; data acquisition: TM, MM, YU, YT, MY, NT, YH, MF, KH, RF, SS, HM; data analysis and interpretation: KS, TM; drafting and finalizing the article: KS, TM; revision of the article critically for important intellectual content: MM, YU, YT, MY, ET, NY, KN. We thank Makoto Kobayashi for the administration work done for the subcommittee of the Japanese Circulation Society Cardiovascular Shock registry and the staff of the following hospitals for data collection. Asahikawa Medical University Hospital, Chikamori Hospital, Dokkyo Medical University, Ebara Hospital, Ehime University Hospital, Fuchu Hospital, Fukuoka University Hospital, Fukushima Medical University Aizu Medical Center, Harasanshin Hospital, Hirosaki University School of Medicine and Hospital, Hiroshima Prefectural Hospital, Hokkaido Cardiovascular Hospital, Hyogo Prefectural Amagasaki General Medical Center, International Goodwill Hospital, Itami City Hospital, IUHW Atami Hospital, JA Hiroshima General Hospital, Japanese Red Cross Kyoto Daini Hospital, Japanese Red Cross Nagoya Daiichi Hospital, Japanese Red Cross Okayama Hospital, JCHO Kyushu Hospital, JCHO Yokohama Chuo Hospital, Jichi Medical University Hospital, Joetsu General Hospital, Juntendo University Shizuoka Hospital, Kashiwa Municipal Hospital, Kawaguchi Municipal Medical Center, Kawasaki Hospital, Kita-Harima Medical Center, Kitano Hospital, Kouseikai Takai Hospital, Kumamoto University Hospital, Kyorin University Hospital, Kyushu University Hospital, Matsue City Hospital, Matsue Red Cross Hospital, Matsumoto Kyoritsu Hospital, Mito Medical Center, Musashino Red Cross Hospital, Nagasaki University Hospital, Nagoya University Graduate School of Medicine, National Hospital Organization Kanazawa Medical Center, National Hospital Organization Kyoto Medical Center, Nihon University Hospital, Nippon Medical School Chiba Hokusoh Hospital, Nishitokyo Central General Hospital, NTT Medical Center Tokyo, Osaka Police Hospital, Osaka Saiseikai Senri Hospital, Osaka University Hospital, Otemae Hospital, Saiseikai Futsukaichi Hospital, Saiseikai Hita Hospital, Saiseikai Kawaguchi General Hospital, Saiseikai Kumamoto Hospital, Saiseikai Niigata Daini Hospital, Saiseikai Yokohamashi Nanbu Hospital, Saitama Medical University International Medical Center, Sakaide City Hospital, Sakakibara Heart Institute, Sasebo City General Hospital, Shiga University of Medical Science Hospital, Shinshu University Hospital, Steel Memorial Muroran Hospital, Sumitomo Hospital, Tohoku Rosai Hospital, Tokai University Hachioji Hospital, Tokushima University Hospital, Tokyo Dental College Ichikawa General Hospital, Tokyo Medical and Dental University Hospital of Medicine, Tokyo Medical University Hospital, Tokyo Metropolitan Tama Medical Center, Tokyo Metropolitan Hiroo Hospital, Toyonaka Municipal Hospital, Tsukazaki Hospital, Yamaguchi Grand Medical Center, Yamaguchi Rosai Hospital, Yokohama City University Hospital, Yokohama Municipal Citizen’s Hospital, Yokohama Rosai Hospital, and Yokohama City University Medical Center (in alphabetical order).

Compliance with ethical standards

Conflict of interest

We have no conflict of interest to declare.

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Copyright information

© Springer Japan KK, part of Springer Nature 2019

Authors and Affiliations

  • Kazuo Sakamoto
    • 1
    • 2
  • Tetsuya Matoba
    • 1
    • 2
    Email author
  • Masahiro Mohri
    • 1
    • 3
  • Yasushi Ueki
    • 1
    • 4
  • Yasuyuki Tsujita
    • 1
    • 5
  • Masao Yamasaki
    • 1
    • 6
  • Nobuhiro Tanaka
    • 1
    • 7
  • Yohei Hokama
    • 1
    • 7
  • Motoki Fukutomi
    • 1
    • 8
  • Katsutaka Hashiba
    • 1
    • 9
  • Rei Fukuhara
    • 1
    • 10
  • Satoru Suwa
    • 1
    • 11
  • Hirohide Matsuura
    • 1
    • 12
  • Eizo Tachibana
    • 1
    • 13
  • Naohiro Yonemoto
    • 1
    • 14
  • Ken Nagao
    • 1
    • 15
  1. 1.JCS Shock Registry Scientific CommitteeTokyoJapan
  2. 2.Department of Cardiovascular MedicineKyushu University HospitalFukuokaJapan
  3. 3.Department of CardiologyJapan Community Healthcare Organization Kyushu HospitalKitakyushuJapan
  4. 4.Emergency and Critical Care CenterShinshu University School of MedicineMatsumotoJapan
  5. 5.Department of Critical and Intensive Care MedicineShiga University of Medical ScienceOtsuJapan
  6. 6.Department of Cardiovascular MedicineNTT Medical CenterTokyoJapan
  7. 7.Department of CardiologyTokyo Medical University Hachioji Medical CenterHachiojiJapan
  8. 8.Division of Cardiovascular MedicineJichi Medical University School of MedicineShimotsukeJapan
  9. 9.Division of CardiologyYokohama City University Medical CenterYokohamaJapan
  10. 10.Department of CardiologyHyogo Prefectural Amagasaki General Medical CenterAmagasakiJapan
  11. 11.Department of Cardiovascular MedicineJuntendo University Shizuoka HospitalIzunokuniJapan
  12. 12.Department of CardiologyMiyazaki Medical Association HospitalMiyazakiJapan
  13. 13.Department of CardiologyKawaguchi Municipal Medical CenterKawaguchiJapan
  14. 14.Department of BiostatisticsKyoto University School of Public HealthKyotoJapan
  15. 15.Cardiovascular CenterNihon University HospitalTokyoJapan

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