{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T15:14:34Z","timestamp":1789398874591,"version":"build-2803163510"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2015,9,4]],"date-time":"2015-09-04T00:00:00Z","timestamp":1441324800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"BLITZ"},{"name":"IN-ACS Outcome"},{"name":"BLITZ-4"},{"name":"MANTRA"},{"name":"EYESHOT"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Despite advances in the management of patients with acute coronary syndrome (ACS), cardiogenic shock (CS) remains the leading cause of death in these patients. We describe the evolution of clinical characteristics, in-hospital management, and outcome of patients with CS complicating ACS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>We analysed data from five Italian nationwide prospective registries, conducted between 2001 and 2014, including consecutive patients with ACS. Out of 28 217 ACS patients enrolled, 1209 (4.3%) had CS: 526 (44%) at the time of admission and 683 (56%) later on during hospitalization. Over the years, a reduction in the incidence of CS was observed, even though this was not statistically significant (P for trend = 0.17). The proportions of CS patients with a history of heart failure declined, whereas the proportion of those with hypertension, renal dysfunction, previous PCI, and AF significantly increased. The use of PCI considerably increased from 2001 to 2014 [19% to 60%; percentage change 41, 95% confidence interval (CI) 29\u201351]. In-hospital mortality of CS patients decreased from 68% (95% CI 59\u201376) in 2001 to 38% (95% CI 29\u201347) in 2014 (percentage change \u221230, 95% CI \u221241 to \u221218). Compared with 2001, the risk of death was significantly lower in all of the registries, with reductions in adjusted mortality between 45% and 66%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Over the last 14 years, substantial changes occurred in the clinical characteristics and management of patients with CS complicating ACS, with a greater use of PCI and a significant reduction in adjusted mortality rate.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejhf.339","type":"journal-article","created":{"date-parts":[[2015,9,4]],"date-time":"2015-09-04T11:02:30Z","timestamp":1441364550000},"page":"1124-1132","source":"Crossref","is-referenced-by-count":120,"title":["Temporal Trends in the Epidemiology, Management, and Outcome of Patients with Cardiogenic Shock Complicating Acute Coronary Syndromes"],"prefix":"10.1093","volume":"17","author":[{"given":"Leonardo","family":"De Luca","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Sciences, European Hospital , Rome ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zoran","family":"Olivari","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Ca\u2019 Foncello Hospital , Treviso ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Farina","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Ospedale A. Manzoni , Lecco ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucio","family":"Gonzini","sequence":"additional","affiliation":[{"name":"ANMCO Research Center , Florence ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donata","family":"Lucci","sequence":"additional","affiliation":[{"name":"ANMCO Research Center , Florence ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Di Chiara","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Ospedale San Antonio Abate , Tolmezzo ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianni","family":"Casella","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Maggiore Hospital , Bologna ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Chiarella","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Azienda Ospedaliera-Universitaria , S. Martino, Genova ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Boccanelli","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Diseases, S. Giovanni-Addolorata Hospital , Rome ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Di Pasquale","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Maggiore Hospital , Bologna ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"De Servi","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Fondazione IRCCS Policlinico San Matteo , Pavia ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco Maria","family":"Bovenzi","sequence":"additional","affiliation":[{"name":"Cardiology Division, Campo di Marte Hospital , Lucca ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele Massimo","family":"Gulizia","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Garibaldi-Nesima Hospital , Catania ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Savonitto","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Ospedale A. Manzoni , Lecco ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2015,9,4]]},"reference":[{"key":"2026011921102474200_ejhf339-bib-0001","doi-asserted-by":"crossref","first-page":"1614","DOI":"10.1136\/heartjnl-2012-302028","article-title":"Management of cardiogenic shock complicating acute coronary syndromes","volume":"99","author":"Tharmaratnam","year":"2013","journal-title":"Heart"},{"key":"2026011921102474200_ejhf339-bib-0002","doi-asserted-by":"crossref","first-page":"686","DOI":"10.1161\/CIRCULATIONAHA.106.613596","article-title":"Cardiogenic shock. Current concepts and improving outcomes","volume":"117","author":"Reynolds","year":"2008","journal-title":"Circulation"},{"key":"2026011921102474200_ejhf339-bib-0003","doi-asserted-by":"crossref","first-page":"2998","DOI":"10.1161\/01.CIR.0000075927.67673.F2","article-title":"Cardiogenic shock complicating acute myocardial infarction: expanding the paradigm","volume":"107","author":"Hochman","year":"2003","journal-title":"Circulation"},{"key":"2026011921102474200_ejhf339-bib-0004","doi-asserted-by":"crossref","first-page":"963","DOI":"10.1016\/j.ahj.2012.03.003","article-title":"Cardiogenic shock complicating acute coronary syndromes: insights from the Global Registry of Acute Coronary Events","volume":"163","author":"Awad","year":"2012","journal-title":"Am Heart J"},{"key":"2026011921102474200_ejhf339-bib-0005","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1001\/jama.294.4.448","article-title":"Trends in management and outcomes of patients with acute myocardial infarction complicated by cardiogenic shock","volume":"294","author":"Babaev","year":"2005","journal-title":"JAMA"},{"key":"2026011921102474200_ejhf339-bib-0006","doi-asserted-by":"crossref","first-page":"e000590","DOI":"10.1161\/JAHA.113.000590","article-title":"Trends in incidence, management, and outcomes of cardiogenic shock complicating ST-elevation myocardial infarction in the United States","volume":"3","author":"Kolte","year":"2014","journal-title":"J Am Heart Assoc"},{"key":"2026011921102474200_ejhf339-bib-0007","doi-asserted-by":"crossref","first-page":"1211","DOI":"10.1161\/CIRCULATIONAHA.108.814947","article-title":"Thirty-year trends (1975 to 2005) in the magnitude of, management of, and hospital death rates associated with cardiogenic shock in patients with acute myocardial infarction: a population-based perspective","volume":"119","author":"Goldberg","year":"2009","journal-title":"Circulation"},{"key":"2026011921102474200_ejhf339-bib-0008","doi-asserted-by":"crossref","first-page":"618","DOI":"10.7326\/0003-4819-149-9-200811040-00005","article-title":"Ten-year trends in the incidence and treatment of cardiogenic shock","volume":"149","author":"Jeger","year":"2008","journal-title":"Ann Intern Med"},{"key":"2026011921102474200_ejhf339-bib-0009","doi-asserted-by":"crossref","first-page":"1616","DOI":"10.1016\/S0195-668X(03)00278-1","article-title":"Epidemiology of acute myocardial infarction in the Italian CCU network: the BLITZ study","volume":"24","author":"Di Chiara","year":"2003","journal-title":"Eur Heart J"},{"key":"2026011921102474200_ejhf339-bib-0010","doi-asserted-by":"crossref","first-page":"71","DOI":"10.3109\/17482941.2012.655296","article-title":"Clinical epidemiology, management and outcome of acute coronary syndromes in the Italian network on acute coronary syndromes (IN-ACS Outcome study)","volume":"14","author":"Rizzello","year":"2012","journal-title":"Acute Card Care"},{"key":"2026011921102474200_ejhf339-bib-0011","first-page":"143","article-title":"The management of acute myocardial infarction in the cardiological intensive care units in Italy: the \u2018BLITZ 4 Qualit\u00e0\u2019 campaign for performance measurement and quality improvement","volume":"1","author":"Olivari","year":"2012","journal-title":"Eur Heart J Acute Cardiovasc Care"},{"key":"2026011921102474200_ejhf339-bib-0012","first-page":"27","article-title":"Management of patients with acute coronary syndromes in real-world practice in Italy: an outcome research study focused on the use of ANTithRombotic Agents: the MANTRA registry","volume":"2","author":"Casella","year":"2013","journal-title":"Eur Heart J Acute Cardiovasc Care"},{"key":"2026011921102474200_ejhf339-bib-0013","article-title":"Contemporary antithrombotic strategies in patients with acute coronary syndromes admitted to cardiac care units in Italy: the EYESHOT study","author":"De Luca","year":"2014","journal-title":"Eur Heart J Acute Cardiovasc Care"},{"key":"2026011921102474200_ejhf339-bib-0014","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1016\/0002-9149(67)90023-9","article-title":"Treatment of myocardial infarction in a coronary care unit. A two year experience with 250 patients","volume":"20","author":"Killip","year":"1967","journal-title":"Am J Cardiol"},{"key":"2026011921102474200_ejhf339-bib-0015","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/0735-1097(88)90158-1","article-title":"Thrombolysis In Myocardial Infarction (TIMI) Trial\u2014Phase I: haemorrhagic manifestations and changes in plasma fibrinogen and the fibrinolytic system in patients treated with recombinant tissue plasminogen activator and streptokinase","volume":"11","author":"Rao","year":"1988","journal-title":"J Am Coll Cardiol"},{"key":"2026011921102474200_ejhf339-bib-0016","doi-asserted-by":"crossref","first-page":"1828","DOI":"10.1093\/eurheartj\/ehq220","article-title":"Shock in acute myocardial infarction: the Cape Horn for trials?","volume":"31","author":"Thiele","year":"2010","journal-title":"Eur Heart J"},{"key":"2026011921102474200_ejhf339-bib-0017","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1002\/ejhf.260","article-title":"Clinical picture and risk prediction of short-term mortality in cardiogenic shock","volume":"17","author":"Harjola","year":"2015","journal-title":"Eur J Heart Fail"},{"key":"2026011921102474200_ejhf339-bib-0018","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/j.jcin.2008.12.002","article-title":"Contemporary management of cardiogenic shock. Age is opportunity","volume":"2","author":"Hochman","year":"2009","journal-title":"J Am Coll Cardiol Interv"},{"key":"2026011921102474200_ejhf339-bib-0019","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1056\/NEJM199908263410901","article-title":"Early revascularization in acute myocardial infarction complicated by cardiogenic shock. SHOCK Investigators. Should we emergently revascularize occluded coronaries for cardiogenic shock","volume":"341","author":"Hochman","year":"1999","journal-title":"N Engl J Med"},{"key":"2026011921102474200_ejhf339-bib-0020","doi-asserted-by":"crossref","first-page":"828","DOI":"10.1016\/S0195-668X(02)00844-8","article-title":"Early revascularization is associated with improved survival in elderly patients with acute myocardial infarction complicated by cardiogenic shock: a report from the SHOCK trial registry","volume":"24","author":"Dzavik","year":"2003","journal-title":"Eur Heart J"},{"key":"2026011921102474200_ejhf339-bib-0021","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1016\/j.jcin.2008.11.006","article-title":"Survival of elderly patients undergoing percutaneous coronary intervention for acute myocardial infarction complicated by cardiogenic shock","volume":"2","author":"Lim","year":"2009","journal-title":"J Am Coll Cardiol Intv"},{"key":"2026011921102474200_ejhf339-bib-0022","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/j.amjcard.2005.02.040","article-title":"Mortality after emergent percutaneous coronary intervention in cardiogenic shock secondary to acute myocardial infarction and usefulness of a mortality prediction model","volume":"96","author":"Klein","year":"2005","journal-title":"Am J Cardiol"},{"key":"2026011921102474200_ejhf339-bib-0023","doi-asserted-by":"crossref","first-page":"1066","DOI":"10.1016\/j.ahj.2003.07.030","article-title":"Outcomes of elderly patients with cardiogenic shock treated with early percutaneous revascularization","volume":"147","author":"Prasad","year":"2004","journal-title":"Am Heart J"},{"key":"2026011921102474200_ejhf339-bib-0024","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1016\/j.ahj.2004.06.004","article-title":"Does current treatment of cardiogenic shock complicating the acute coronary syndromes comply with guidelines?","volume":"149","author":"Iakobishvili","year":"2005","journal-title":"Am Heart J"},{"key":"2026011921102474200_ejhf339-bib-0025","doi-asserted-by":"crossref","first-page":"664","DOI":"10.1093\/eurheartj\/ehi729","article-title":"Emergency revascularization in patients with cardiogenic shock on admission: a report from the SHOCK trial and registry","volume":"27","author":"Jeger","year":"2006","journal-title":"Eur Heart J"},{"key":"2026011921102474200_ejhf339-bib-0026","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.2459\/JCM.0b013e328304ae7f","article-title":"Cardiogenic shock developing in the coronary care unit in patients with ST-elevation myocardial infarction","volume":"9","author":"De Luca","year":"2008","journal-title":"J Cardiovasc Med"}],"container-title":["European Journal of Heart Failure"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fejhf.339","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/eurjhf\/article-pdf\/17\/11\/1124\/66422267\/eurjhf_17_11_1124.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eurjhf\/article-pdf\/17\/11\/1124\/66422267\/eurjhf_17_11_1124.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T02:10:58Z","timestamp":1768875058000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eurjhf\/article\/17\/11\/1124\/8426444"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,9,4]]},"references-count":26,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2015,9,4]]},"published-print":{"date-parts":[[2015,11,1]]}},"URL":"https:\/\/doi.org\/10.1002\/ejhf.339","relation":{},"ISSN":["1388-9842","1879-0844"],"issn-type":[{"value":"1388-9842","type":"print"},{"value":"1879-0844","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2015,11]]},"published":{"date-parts":[[2015,9,4]]}}}