{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T08:01:28Z","timestamp":1790236888220,"version":"4.1.0"},"reference-count":26,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2023,3,30]],"date-time":"2023-03-30T00:00:00Z","timestamp":1680134400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Cardiogenic shock (CS) continues to be a severe and fatal complication of acute coronary syndrome (ACS). CS patients have a high mortality rate despite significant progress in primary reperfusion, the management of heart failure and the expansion of mechanical circulatory support strategies. The present study addressed the clinical characteristics, management, and outcomes of ACS patients complicated with CS. Methods: We performed an observational study, using the 2000\u20132013 Acute Coronary Syndrome Israeli Surveys (ACSIS) database and identified hospitalizations of ACS patients complicated with CS. Patients\u2019 demographics and clinical characteristics, complications and outcomes were evaluated. We assessed the outcomes of ACS patients with CS at arrival (on the day of admission) compared with ACS patients who arrived without CS and developed CS during hospitalization. Results: The cohort included 13,434 patients with ACS diagnoses during the study period. Of these, 4.2% were complicated with CS; 224 patients were admitted with both ACS and CS; while 341 ACS patients developed CS only during the hospitalization period. The latter patients had significantly higher rates of MACEs compared with the group of ACS patients who presented with CS at arrival (73% vs. 51%; p &lt; 0.0001). Similarly, the rates of in-hospital mortality (55% vs. 36%; p &lt; 0.0001), 30-day mortality (64% vs. 50%; p = 0.0013) and 1-year mortality (73% vs. 59%; p = 0.0016) were higher in ACS patients who developed CS during hospitalization vs. ACS patients with CS at admission. There was a significant decrease in 1-year mortality trends during the 13 years of this study presented in ACS patients from both groups. Conclusions: Patients who developed CS during hospitalization had higher mortality and MACE rates compared with those who presented with CS at arrival. Further studies should focus on this subgroup of high-risk patients.<\/jats:p>","DOI":"10.3390\/jcm12072603","type":"journal-article","created":{"date-parts":[[2023,3,30]],"date-time":"2023-03-30T03:17:35Z","timestamp":1680146255000},"page":"2603","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Outcomes of Acute Coronary Syndrome Patients Who Presented with Cardiogenic Shock versus Patients Who Developed Cardiogenic Shock during Hospitalization"],"prefix":"10.3390","volume":"12","author":[{"given":"Zahi","family":"Abu Ghosh","sequence":"first","affiliation":[{"name":"Department of Cardiology, Hadassah Medical Center, The Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9190501, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Offer","family":"Amir","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hadassah Medical Center, The Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9190501, Israel"},{"name":"The Azrieli Faculty of Medicine in the Galilee, Bar-Ilan University, Safed 5290002, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9582-770X","authenticated-orcid":false,"given":"Shemy","family":"Carasso","sequence":"additional","affiliation":[{"name":"The Azrieli Faculty of Medicine in the Galilee, Bar-Ilan University, Safed 5290002, Israel"},{"name":"The Jesselson Integrated Heart Center, Shaare Zedek Medical Center, Jerusalem 9103102, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Planer","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hadassah Medical Center, The Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9190501, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronny","family":"Alcalai","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hadassah Medical Center, The Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9190501, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mordechai","family":"Golomb","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hadassah Medical Center, The Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9190501, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gil","family":"Dagan","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hadassah Medical Center, The Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9190501, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eran","family":"Kalmanovich","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Shamir Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel Aviv-Yafo 6997801, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Blatt","sequence":"additional","affiliation":[{"name":"Kaplan Heart Center, Hebrew University, Jerusalem 9190501, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1922-9174","authenticated-orcid":false,"given":"Gabby","family":"Elbaz-Greener","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hadassah Medical Center, The Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9190501, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"876","DOI":"10.1016\/j.jcin.2022.01.283","article-title":"Percutaneous Coronary Intervention Volume and Cardiac Surgery Availability Effect on Acute Coronary Syndrome-Related Cardiogenic Shock","volume":"15","author":"Noaman","year":"2022","journal-title":"JACC Cardiovasc. Interv."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e011991","DOI":"10.1161\/JAHA.119.011991","article-title":"Cardiogenic Shock","volume":"8","author":"Vahdatpour","year":"2019","journal-title":"J. Am. Heart Assoc."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2511","DOI":"10.1001\/jama.295.21.2511","article-title":"Early revascularization and long-term survival in cardiogenic shock complicating acute myocardial infarction","volume":"295","author":"Hochman","year":"2006","journal-title":"JAMA"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1056\/NEJM199908263410901","article-title":"Early revascularization in acute myocardial infarction complicated by cardiogenic shock","volume":"341","author":"Hochman","year":"1999","journal-title":"N. Engl. J. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1223","DOI":"10.1093\/eurheartj\/ehv051","article-title":"Management of cardiogenic shock","volume":"36","author":"Thiele","year":"2015","journal-title":"Eur. Heart J."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e021061","DOI":"10.1161\/JAHA.121.021061","article-title":"Fifteen-Year Trends in Incidence of Cardiogenic Shock Hospitalization and In-Hospital Mortality in the United States","volume":"10","author":"Osman","year":"2021","journal-title":"J. Am. Heart Assoc."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1173","DOI":"10.1002\/ccd.28307","article-title":"Improved outcomes associated with the use of shock protocols: Updates from the national cardiogenic shock initiative","volume":"93","author":"Basir","year":"2019","journal-title":"Catheter. Cardiovasc. Interv."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"903","DOI":"10.1016\/j.jchf.2020.08.012","article-title":"Complete hemodynamic profiling with pulmonary artery catheters in cardiogenic shock is associated with lower in-hospital mortality","volume":"8","author":"Garan","year":"2020","journal-title":"JACC Heart Fail."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1659","DOI":"10.1016\/j.jacc.2018.12.084","article-title":"Standardized team-based care for cardiogenic shock","volume":"73","author":"Tehrani","year":"2019","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1007\/s11936-020-0804-6","article-title":"Mechanical circulatory support in patients with cardiogenic shock","volume":"22","author":"Alkhouli","year":"2020","journal-title":"Curr. Treat. Options Cardiovasc. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.amjcard.2016.03.054","article-title":"Comparison of Noninvasively and Invasively Managed Patients, With or Without Revascularization in Non-ST Elevation Myocardial Infarction (from the Acute Coronary Syndrome Israeli Survey)","volume":"118","author":"Blatt","year":"2016","journal-title":"Am. J. Cardiol."},{"key":"ref_12","first-page":"216","article-title":"Bypassing the emergency room to reduce door-to-balloon time and improve outcomes of patients with ST elevation myocardial infarction: The Acute Coronary Syndrome Israeli Survey experience","volume":"13","author":"Lubovich","year":"2011","journal-title":"Isr. Med. Assoc. J."},{"key":"ref_13","first-page":"547","article-title":"Prognostic implications of increased cardiac biomarkers and ST segment depression in non-ST elevation acute coronary syndromes: Lessons from the acute coronary syndrome Israeli survey (ACSIS) 2002","volume":"92","author":"Hasdai","year":"2006","journal-title":"Heart"},{"key":"ref_14","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":"ref_15","doi-asserted-by":"crossref","first-page":"1035","DOI":"10.1016\/S0002-9149(01)01457-6","article-title":"Predictive value of the Killip classification in patients undergoing primary percutaneous coronary intervention for acute myocardial infarction","volume":"87","author":"DeGeare","year":"2001","journal-title":"Am. J. Cardiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e6","DOI":"10.1161\/CIR.0000000000000741","article-title":"Adults in the Cardiac Intensive Care Unit: Factoring Geriatric Syndromes in the Management, Prognosis, and Process of Care: A Scientific Statement From the American Heart Association","volume":"141","author":"Damluji","year":"2020","journal-title":"Circulation"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e16","DOI":"10.1161\/CIR.0000000000000985","article-title":"Mechanical Complications of Acute Myocardial Infarction: A Scientific Statement From the American Heart Association","volume":"144","author":"Damluji","year":"2021","journal-title":"Circulation"},{"key":"ref_18","first-page":"CD009669","article-title":"Inotropic agents and vasodilator strategies for the treatment of cardiogenic shock or low cardiac output syndrome","volume":"1","author":"Schumann","year":"2018","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1840","DOI":"10.1001\/jama.2021.18323","article-title":"Cardiogenic shock after acute myocardial infarction: A review","volume":"326","author":"Samsky","year":"2021","journal-title":"JAMA"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"71","DOI":"10.31083\/j.rcm2302071","article-title":"Mechanical circulatory support in acute myocardial infarction complicated by cardiogenic shock","volume":"23","author":"Ayman","year":"2022","journal-title":"Rev. Cardiovasc. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1097\/MCC.0000000000000845","article-title":"Epidemiology and causes of cardiogenic shock","volume":"27","author":"Berg","year":"2021","journal-title":"Curr. Opin. Crit. Care"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1002\/ejhf.779","article-title":"Left ventricular assist device therapy in advanced heart failure: Patient selection and outcomes","volume":"19","author":"Gustafsson","year":"2017","journal-title":"Eur. J. Heart Fail."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"3599","DOI":"10.1093\/eurheartj\/ehab368","article-title":"2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure","volume":"42","author":"McDonagh","year":"2021","journal-title":"Eur. Heart J."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Vallabhajosyula, S., Ya\u2019Qoub, L., Kumar, V., Verghese, D., Subramaniam, A.V., Patlolla, S.H., Desai, V.K., Sundaragiri, P.R., Cheungpasitporn, W., and Deshmukh, A.J. (2020). Contemporary National Outcomes of Acute Myocardial Infarction-Cardiogenic Shock in Patients with Prior Chronic Kidney Disease and End-Stage Renal Disease. J. Clin. Med., 9.","DOI":"10.3390\/jcm9113702"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Krisanapan, P., Pattharanitima, P., Thongprayoon, C., and Cheungpasitporn, W. (2022). Recent Advances in Understanding of Cardiovascular Diseases in Patients with Chronic Kidney Disease. J. Clin. Med., 11.","DOI":"10.3390\/jcm11164653"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1016\/j.amjmed.2005.08.057","article-title":"Chronic kidney disease in patients with non-ST-segment elevation acute coronary syndromes","volume":"119","author":"Han","year":"2006","journal-title":"Am. J. Med."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/7\/2603\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:06:54Z","timestamp":1760123214000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/7\/2603"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,30]]},"references-count":26,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2023,4]]}},"alternative-id":["jcm12072603"],"URL":"https:\/\/doi.org\/10.3390\/jcm12072603","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,30]]}}}