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Prognostic impact of SCAI shock severity classes in AMI-related cardiogenic shock: a sub-study of the ECLS-SHOCK trial

Aims The Society for Cardiovascular Angiography and Interventions (SCAI) Classification provides risk stratification of patients with acute myocardial infarction complicated by cardiogenic shock (AMI-CS). This sub-study of the ECLS-SHOCK trial investigates the prognostic impact of SCAI stages in AMI...

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Main Authors: Pöss, Janine (Author) , Jentzer, Jacob (Author) , Desch, Steffen (Author) , Feistritzer, Hans-Josef (Author) , Freund, Anne (Author) , Roßberg, Michelle (Author) , Jung, Christian (Author) , Ouarrak, Taoufik (Author) , Schneider, Steffen (Author) , Akın, Ibrahim (Author) , Rassaf, Tienush (Author) , Thevathasan, Tharusan (Author) , Zeymer, Uwe (Author) , Thiele, Holger (Author)
Format: Article (Journal)
Language:English
Published: 2025
In: ESC heart failure
Year: 2025, Pages: 1-10
ISSN:2055-5822
DOI:10.1002/ehf2.15446
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.1002/ehf2.15446
Verlag, kostenfrei, Volltext: https://onlinelibrary.wiley.com/doi/abs/10.1002/ehf2.15446
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Author Notes:Janine Pöss, Jacob Jentzer, Steffen Desch, Hans-Josef Feistritzer, Anne Freund, Michelle Roßberg, Christian Jung, Taoufik Ouarrak, Steffen Schneider, Ibrahim Akin, Tienush Rassaf, Tharusan Thevathasan, Uwe Zeymer and Holger Thiele
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Summary:Aims The Society for Cardiovascular Angiography and Interventions (SCAI) Classification provides risk stratification of patients with acute myocardial infarction complicated by cardiogenic shock (AMI-CS). This sub-study of the ECLS-SHOCK trial investigates the prognostic impact of SCAI stages in AMI-CS and the influence of SCAI stages on the effect of extracorporeal life support (ECLS) therapy in AMI-CS patients. Methods Patients with AMI-CS enrolled in the multicentre, randomized ECLS-SHOCK trial were included. The outcomes, treatment effect and safety of ECLS were stratified according to SCAI stage at admission using a post-hoc classification. Results From a total of 417 patients enrolled in the ECLS-SHOCK trial between June 2019 and November 2022, 51.6% (n = 215), 13.4% (n = 56) and 35.0% (n = 146) presented in SCAI Stages C, D and E, respectively. SCAI stages were associated with the risk of 30 day all-cause mortality (C vs. D vs. E: 32.6% vs. 67.9% vs. 64.4%, P < 0.001), with rates of renal replacement therapy at 30 days (C vs. D vs. E: 7.0% vs. 19.6% vs. 13.7%, P = 0.03) and with poor neurological outcomes (C vs. D vs. E: 17.2% vs. 44.4% vs. 36.5%, P < 0.001). No interaction was observed between SCAI stage and the treatment effect of ELCS on 30 day all-cause mortality (ELCS vs. control SCAI C: 32.7% vs. 32.4%; SCAI D: 68.4% vs. 66.7%; SCAI E: 59.7% vs. 68.4%, P for interaction = 0.65). Conclusions In AMI-CS patients included in the ECLS-SHOCK trial, SCAI stages at admission were predictive for mortality and for the incidence of safety events. The efficacy of ECLS treatment was not affected by SCAI stage.
Item Description:Erstmals veröffentlicht: 13. Oktober 2025
Gesehen am 25.11.2025
Physical Description:Online Resource
ISSN:2055-5822
DOI:10.1002/ehf2.15446

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