4998Current use and impact on 30-day mortality of pulmonary artery catheter in cardiogenic shock patients: results from the CardShock Study

Background: Cardiogenic Shock (CS) is the most life-threatening manifestation of heart failure (HF). Its complexity and high mortality, near 40%, would justify the need for invasive monitoring with a pulmonary artery catheter (PAC). Randomized clinical trials have failed to demonstrate clinical benefit of PAC use in critically ill patients, but CS patients were grossly underrepresented. Purpose: To describe the real-world use of PAC in patients with CS and to evaluate its prognostic impact on short-term mortality. Methods: This is a sub-study of the CardShock study a prospective, multicenter cohort aimed to describe the contemporary clinical and management characteristics in patients with CS. The use of PAC was within the discretion of the physician in charge. The primary endpoint was overall 30-day mortality. Results: The CardShock study included 219 patients; PAC was used in 82 patients (37.4%). Management was more aggressive in those with PAC (table). Overall 30-day mortality was 38.6%. PAC use did not affect mortality [OR: 1.24 (95% CI 0.60–2.56) p=0.56], in a multivariate analysis adjusted by a propensity score (including the history of prior myocardial infarction, inotropic use at admission, acute coronary syndrome as the etiology of shock, mechanical ventilation, and assist devices use).