Thread by @BenediktSchrage

💡New research from our group @ESC_Journals indicates that #MCS might improve outcomes in patients with #heartfailure related #cardiogenicshock Let me walk you through it!

Actually, #cardiogenicshock has, for many years, been seen as predominantly caused by #myocardialinfarction However, recent evidence suggests that non-ischemic causes match it in frequency and impact on outcomes ‼️
pubmed.ncbi.nlm.nih.gov/30879324/

onlinelibrary.wiley.com/doi/full/10.10…

This is concerning 🧐, as most RCTs on use of #MCS in #cardiogenicshock focus on patients with #myocardialinfarction and exclude those with #heartfailure related #cardiogenicshock resulting in an overall low level of evidence for this patient population
pubmed.ncbi.nlm.nih.gov/34145680/

To address this gap in evidence, we aimed to explore the potential value of #MCS as a treatment option in N=890 patients with #heartfailure related #cardiogenicshock from a dedicated multicenter, international registry 🌎
onlinelibrary.wiley.com/share/QZWY6ANE…

In a 1:1 propensity-score matched analysis, #MCS use was associated with a 24% relative reduction in 30-day all-cause mortality risk 🔻💀, but also with more complications (e.g., bleedings, access-site related ischemia) 🔺🩸.

Also, we observed a relevant interaction between this finding and #cardiogenicshock severity assessed by #SCAI class, indicating a relative mortality risk reduction especially in patients with deteriorating #cardiogenicshock

As this is a retrospective, non-randomized analysis, its results are most certainly impacted by selection bias and unmeasured/unknown confounders, so that causality cannot be concluded from this.

However, it is a first step to generate evidence for a field where evidence is scarce, and especially points out the need to investigate the use of #MCS in patients with #heartfailure related #cardiogenicshock by dedicated randomized controlled trials.

Especially the finding on the interaction with #cardiogenicshock severity as measured by #SCAI class is interesting, as it indicates potential for improved patient selection (e.g., improving the benefit-risk-ratio)

Ultimately, I want to express my gratitude to all collaborators, its a team effort!
@dirkwestermann @JonaSundermeyer @JeroenDauw @ZouDindaneMD @IngoEitel @StefanKluge4 @NormanMangner @Sportmedizin @MichalPazdernik @ICUDocAP @TRassafMD @cmscopy88 @PCSchulzeMD @thiele_holger