{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T12:03:38Z","timestamp":1784721818126,"version":"3.55.0"},"reference-count":32,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T00:00:00Z","timestamp":1756080000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Mortality in patients with cardiogenic shock (CS) remains high despite advanced treatment strategies in CS patients, underlining the need for the identification of predictors of prognosis in CS patients. Therefore, the present study investigates the prognostic impact of coronary chronic total occlusions (CTO) in patients with CS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All consecutive patients being acutely admitted with CS to an intensive care unit (ICU) and undergoing invasive coronary angiography (ICA) from 2019 to 2021 were included, irrespective of the etiology of CS. Patients with at least one CTO were compared to non\u2010CTO patients with regard to the risk of all\u2010cause mortality at 30 days. Further risk stratification was performed according to the extent of coronary artery disease (CAD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 192 CS patients undergoing ICA during index hospitalization were included. At least one CTO was present in 24% of CS patients. Patients with CTO were older (median 78 vs. 68;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001) and presented more frequently with non\u2010ST\u2010elevated myocardial infarction (21% vs. 12%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.048). The presence of a CTO was associated with higher rates of 30\u2010days all\u2010cause mortality (70.2% vs. 47.6%; HR\u2009=\u20091.783, 95% CI 1.176\u22122.702;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.009), even after multivariable adjustment (adjusted HR\u2009=\u20091.898; 95% CI 1.116\u22123.229;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.018). Patients with CTO were accompanied by an even higher 30\u2010days all\u2010cause mortality as compared to patients with multi\u2010vessel CAD without CTO (adjusted HR\u2009=\u20091.723; 95% CI 1.058\u22122.805;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.029).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Coronary CTO are common in patients with CS and represent an independent predictor of all\u2010cause mortality at 30 days.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ccd.70116","type":"journal-article","created":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T05:50:40Z","timestamp":1756187440000},"page":"2805-2815","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Prevalence and Prognostic Impact of Coronary Chronic Total Occlusions in Patients With Cardiogenic Shock"],"prefix":"10.1002","volume":"106","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5970-0093","authenticated-orcid":false,"given":"Michael","family":"Behnes","sequence":"first","affiliation":[{"name":"Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim Heidelberg University Baden\u2010W\u00fcrttemberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moritz","family":"Schmidberger","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim Heidelberg University Baden\u2010W\u00fcrttemberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0869-4855","authenticated-orcid":false,"given":"Giuseppe","family":"Vadal\u00e0","sequence":"additional","affiliation":[{"name":"Division of Cardiology University Hospital \u201cP. Giaccone\u201d Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0160-7317","authenticated-orcid":false,"given":"Alice","family":"Moroni","sequence":"additional","affiliation":[{"name":"Division of Cardiology Imelda Hospital Bonheiden Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan\u2010Luis","family":"Guiterrez\u2010Chico","sequence":"additional","affiliation":[{"name":"Bundeswehrzentralkrankenhaus Koblenz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stylianos","family":"Pyxaras","sequence":"additional","affiliation":[{"name":"Department of Cardiology Klinikum F\u00fcrth F\u00fcrth Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Bufe","sequence":"additional","affiliation":[{"name":"Interventional Cardiology, HELIOS Klinikum Wuppertal, Herzzentrum Universit\u00e4t Witten\/Herdecke Herdecke Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Kr\u00f6tz","sequence":"additional","affiliation":[{"name":"Department of Cardiology Klinikum Starnberg Starnberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8119-8941","authenticated-orcid":false,"given":"Kambis","family":"Mashayekhi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Cardiology Mediclin Heart Centre Lahr Lahr Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Ayoub","sequence":"additional","affiliation":[{"name":"Division of Cardiology and Angiology Heart Center University of Bochum\u2010Bad Oeynhausen Bad Oeynhausen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonas","family":"Rusnak","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim Heidelberg University Baden\u2010W\u00fcrttemberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Abumayyaleh","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim Heidelberg University Baden\u2010W\u00fcrttemberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonas","family":"Dudda","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim Heidelberg University Baden\u2010W\u00fcrttemberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathrin","family":"Weidner","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim Heidelberg University Baden\u2010W\u00fcrttemberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1974-6147","authenticated-orcid":false,"given":"Ibrahim","family":"Akin","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim Heidelberg University Baden\u2010W\u00fcrttemberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8171-7617","authenticated-orcid":false,"given":"Tobias","family":"Schupp","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim Heidelberg University Baden\u2010W\u00fcrttemberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,8,25]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.121.021061"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/hpc.0000000000000272"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)01818-X"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1710261"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.260"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.2991\/jegh.k.201217.001"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.4244\/eij-d-23-00749"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2020.11.009"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2012.07.008"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcha.2019.100414"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.27330"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2016.06.007"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2016.04.031"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.12.007"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2024.07.028"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11247295"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehad191"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy462"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.592"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab368"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jscai.2021.100008"},{"key":"e_1_2_9_23_1","first-page":"219","article-title":"The SYNTAX Score: An Angiographic Tool Grading the Complexity of Coronary Artery Disease","volume":"1","author":"Sianos G.","year":"2005","journal-title":"EuroIntervention: Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.4244\/eij-d-18-00826"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1161\/circoutcomes.123.010490"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2018.03.042"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.4244\/EIJ-D-18-00496"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00392-020-01758-y"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.4244\/eij-d-17-00451"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0103850"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/ehf2.13202"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1161\/circoutcomes.119.005618"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurjhf\/hfs182"}],"container-title":["Catheterization and Cardiovascular Interventions"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.70116","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T19:05:11Z","timestamp":1762283111000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccd.70116"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,25]]},"references-count":32,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1002\/ccd.70116"],"URL":"https:\/\/doi.org\/10.1002\/ccd.70116","archive":["Portico"],"relation":{},"ISSN":["1522-1946","1522-726X"],"issn-type":[{"value":"1522-1946","type":"print"},{"value":"1522-726X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,25]]},"assertion":[{"value":"2025-06-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-19","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-25","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}