Clinical Outcomes of Cardiogenic Shock due to Spontaneous Coronary Artery Dissection versus Cardiogenic Shock due to Coronary Artery Disease

Chayakrit Krittanawong; Yusuf Kamran Qadeer; Song Peng Ang; Zhen Wang; Mahboob Alam; Samin Sharma; Hani Jneid

doi:10.1097/HPC.0000000000000354

Clinical Outcomes of Cardiogenic Shock due to Spontaneous Coronary Artery Dissection versus Cardiogenic Shock due to Coronary Artery Disease

Crit Pathw Cardiol. 2024 Mar 7. doi: 10.1097/HPC.0000000000000354. Online ahead of print.

Authors

Chayakrit Krittanawong¹, Yusuf Kamran Qadeer², Song Peng Ang³, Zhen Wang^{4

5}, Mahboob Alam⁶, Samin Sharma⁷, Hani Jneid^{1

2

3

4

5

6

8

7}

Affiliations

¹ Cardiology Division, NYU Langone Health and NYU School of Medicine, New York, NY.
² Division of Cardiology, Department of Medicine, Henry Ford Hospital, Detroit, Michigan.
³ Division of Internal Medicine, Rutgers Health/Community Medical Center, NJ, USA.
⁴ Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN.
⁵ Division of Health Care Policy and Research, Department of Health Sciences Research, Mayo Clinic, Rochester, MN.
⁶ The Texas Heart Institute, Baylor College of Medicine, Houston, TX.
⁷ John Sealy Distinguished Centennial Chair in Cardiology, Chief, Division of Cardiology, University of Texas Medical Branch, Houston, TX, USA.
⁸ Cardiac Catheterization Laboratory of the Cardiovascular Institute, Mount Sinai Hospital, New York, New York.

PMID: 38467033
DOI: 10.1097/HPC.0000000000000354

Abstract

Spontaneous coronary artery dissection (SCAD) can be treated conservatively. However, some SCAD patients can develop cardiogenic shock (CS). We evaluated the outcomes of SCAD-related CS using data from a national population-based cohort study from January 1, 2016, to December 30, 2019. In our study of 32,640 patients with SCAD, about 10.6% of patients presented with cardiogenic shock. We found that SCAD patients with cardiogenic shock had higher mortality as well as greater complications including use of mechanical circulatory devices, arrythmias, respiratory support, and acute heart failure compared to those without cardiogenic shock. When comparing cardiogenic shock due to SCAD with that due to coronary artery disease (CAD), we found that while mortality rates were similar, those with cardiogenic shock due to SCAD were associated with higher risk of use of mechanical circulatory support, major bleeding, blood transfusion and respiratory failure.