Advanced Cardiogenic-shock Team versus standard care in cardiogenic SHOCK: a single centre service evaluation project
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Le résumé fourni par la source
BACKGROUND: Cardiogenic shock (CS) complicating acute myocardial infarction (AMI) carries high mortality. Early revascularisation improves survival, but the effect of structured multidisciplinary care on outcomes remains underexplored. METHODS AND RESULTS: ACT-SHOCK is a service evaluation at a UK tertiary cardiac centre. Between May 2023 and May 2024, 82 patients with AMI-related CS requiring emergent percutaneous coronary intervention (PCI) were identified using protocolised physiological criteria and managed by an Advanced Cardiogenic-Shock Team (ACT). The ACT comprised interventional cardiologists, intensivists, anaesthetists, critical care staff and cardiac physiologists, coordinating PCI and ongoing care. Outcomes were compared with 83 historical controls from the year preceding ACT roll-out, who received standard care without ACT activation. Primary endpoints were 30-day and 1-year all-cause mortality; secondary outcomes included predictors of 30-day mortality.Within the ACT cohort, elevated lactate, critical care admission, invasive ventilation, out-of-hospital cardiac arrest and Society for Cardiovascular Angiography and Interventions (SCAI) Shock Stage E at first medical contact predicted 1-year mortality. Adjusted analyses showed ACT management was associated with lower 1-year mortality compared with standard care (HR 0.53, 95% CI 0.30 to 0.92; p=0.026). Although 30-day mortality was lower in the ACT group, this did not reach statistical significance (HR 0.71, 95% CI 0.39 to 1.29; p=0.26). Escalation from coronary care to critical care during the recovery phase occurred more promptly in the ACT group (9.7% vs 2.4%, p=0.09). At 24 hours, a smaller proportion of ACT patients remained in SCAI stages D/E compared with standard care (42% vs 48%; p=0.003). CONCLUSIONS: Implementation of physiological criteria to identify CS and activation of a multidisciplinary ACT in a UK tertiary centre was associated with earlier detection and improved 1-year survival in AMI-related CS. These pilot data support further study across multiple UK centres to inform national policy and standardise care pathways.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Advanced Cardiogenic-shock Team versus standard care in cardiogenic SHOCK: a single centre service evaluation project
- Date Crossref
- 01/01/2026
- Éditeur
- BMJ
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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University Hospitals Bristol NHS Foundation Trust pays non établi dans la noticeÉtablissement de santé
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University of Bristol Translation Health Sciences pays non établi dans la noticeUniversité ou école supérieure
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University Hospitals Bristol and Weston NHS Foundation Trust Cardiology pays non établi dans la noticeÉtablissement de santé
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Essex Cardiothoracic Centre pays non établi dans la noticeÉtablissement de santé
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Anglia Ruskin University pays non établi dans la noticeUniversité ou école supérieure
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King's College London pays non établi dans la noticeUniversité ou école supérieure
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King's College Hospital NHS Foundation Trust Cardiology pays non établi dans la noticeÉtablissement de santé
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Barts Health NHS Trust pays non établi dans la noticeÉtablissement de santé
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University Hospital Southampton NHS Foundation Trust Wessex Cardiothoracic Centre pays non établi dans la noticeÉtablissement de santé
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University of Southampton pays non établi dans la noticeUniversité ou école supérieure
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Mid and South Essex NHS Foundation Trust Essex Cardiothoracic Centre pays non établi dans la noticeOrganisation à but non lucratif
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School of Medicine and MTRC pays non établi dans la noticeUniversité ou école supérieure
University Hospitals Bristol NHS Foundation Trust, Translation Health Sciences — University of Bristol et Cardiology — University Hospitals Bristol and Weston NHS Foundation Trust, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.