Evidence map›Paper›PMID 40956069›Full record

ArticleEuropean journal of heart failure2025

Impact of comorbidity burden on outcome in patients with cardiogenic shock: A Cardiogenic Shock Working Group analysis.

Jonas Sundermeyer, Song Li, Van-Khue Ton, Rachna Kataria, Elric Zweck, Kevin John, Manreet K Kanwar, Jaime Hernandez-Montfort, Shashank S Sinha, A Reshad Garan and 43 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in European journal of heart failure, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

53 authors.

Jonas SundermeyerThe Cardiovascular Center, Tufts Medical Center, Boston, MA, USA.ORCID https://orcid.org/0000-0002-0076-2211
Song LiInstitute for Advanced Cardiac Care, Medical City Healthcare, Dallas, TX, USA.
Van-Khue TonMassachusetts General Hospital, Boston, MA, USA.
Rachna KatariaBrown University Health Cardiovascular Institute, Providence, RI, USA.
Elric ZweckDepartment of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany.
Kevin JohnThe Cardiovascular Center, Tufts Medical Center, Boston, MA, USA.
Manreet K KanwarUniversity of Chicago, Chicago, IL, USA.
Jaime Hernandez-MontfortBaylor Scott & White Health, Advanced Heart Failure Program Clinic, Temple, TX, USA.
Shashank S SinhaInova Heart and Vascular Institute, Falls Church, VA, USA.
A Reshad GaranBeth Israel Deaconess Medical Center, Boston, MA, USA.
Jacob AbrahamCenter for Cardiovascular Analytics, Research, & Data Science (CARDS), Providence St. Joseph Research Network, Portland, OR, USA.
Vanessa BlumerDivision of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA, USA.
Ajar KocharCardiovascular Institute at Allegheny Health Network, Pittsburgh, PA, USA.
Karthikeyan RanganathanUniversity of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Gavin W HickeyUniversity of Oklahoma Health Science Center, Oklahoma City, OK, USA.
Mohit PahujaUniversity of Nebraska Medical Center, Omaha, NE, USA.
Scott LundgrenNorthwestern Medicine, Chicago, IL, USA.
Sandeep NathanUniversity of Chicago, Chicago, IL, USA.
Esther VorovichBaylor University Medical Center, Dallas, TX, USA.
Shelley HallUniversity of Texas Medical Branch, Galveston, TX, USA.
Wissam KhalifeMaine Medical Center, Portland, OR, USA.
Andrew SchwartzmanHouston Methodist Research Institute, Houston, TX, USA.
Ju KimThomas Jefferson University Hospital, Philadelphia, PA, USA.
Oleg Alec VishnevskyColumbia University Irving Medical Center, New York, NY, USA.
Justin FriedUT Southwestern, Dallas, TX, USA.
Maryjane FarrAtrium Health Sanger Heart and Vascular Institute, Charlotte, NC, USA.
Joseph MishkinBanner University Medical Center, Phoenix, AZ, USA.
I-Hui ChangIndiana University School of Medicine, Indianapolis, IN, USA.
Onyedika IlonzeInstituto Nacional de Cardiologia Ignacio Chavez, Mexico City, Mexico.
Alexandra AriasDivision of Cardiovascular Intensive Care, Nippon Medical School Hospital, Tokyo, Japan.
Jun NakataOregon Health State University, Portland, OR, USA.ORCID https://orcid.org/0000-0003-2476-1050
Jeffrey MarbachTampa General Hospital, Tampa, FL, USA.
Hiram BezerraTriStar Centennial Medical Center, Nashville, TN, USA.
Ann GageUniversity of Pennsylvania, Philadelphia, PA, USA.
Joyce WaldUniversity of Washington Medical Center, Seattle, WA, USA.
Sunu ThomasJohns Hopkins University, Baltimore, MD, USA.
Faisal RahmanAtlantic Health System, Morristown, NJ, USA.
Amirali MasoumiBaylor Scott and White, Plano, TX, USA.
Aasim AfzalBaylor Scott and White, Fort Worth, TX, USA.
Salman GoharBrown University Health, Providence, RI, USA.
Rachel GoodmanThe Cardiovascular Center, Tufts Medical Center, Boston, MA, USA.
Karol D WalecThe Cardiovascular Center, Tufts Medical Center, Boston, MA, USA.
Peter NatovThe Cardiovascular Center, Tufts Medical Center, Boston, MA, USA.
Borui LiThe Cardiovascular Center, Tufts Medical Center, Boston, MA, USA.
Paavni SangalThe Cardiovascular Center, Tufts Medical Center, Boston, MA, USA.
Qiuyue KongThe Cardiovascular Center, Tufts Medical Center, Boston, MA, USA.
Peter ZazzaliThe Cardiovascular Center, Tufts Medical Center, Boston, MA, USA.
Neil M HarwaniThe Cardiovascular Center, Tufts Medical Center, Boston, MA, USA.
Saraschandra VallabhajosyulaBrown University Health Cardiovascular Institute, Providence, RI, USA.
Arvind BhimarajHouston Methodist Hospital, Houston, TX, USA.
Claudius MahrInstitute for Advanced Cardiac Care, Medical City Healthcare, Dallas, TX, USA.
Daniel BurkhoffCardiovascular Research Foundation, New York, NY, USA.
Navin K KapurThe Cardiovascular Center, Tufts Medical Center, Boston, MA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsComorbidity burden is a major determinant of outcomes. Its prognostic impact on cardiogenic shock (CS) across CS subtypes remains insufficiently characterized. We aimed to characterize the prevalence and distribution of comorbidities in CS, assess their impacts on outcomes, and identify high-risk comorbidity patterns in all-cause, acute myocardial infarction-related (AMI-CS) and heart failure-related CS (HF-CS). METHODS AND

resultsCardiogenic shock patients from the multicentre Cardiogenic Shock Working Group (CSWG) registry (2020-2024) were analysed. We used adjusted logistic regression models to assess the impact of comorbidities individually, in combination, and as a cumulative burden on in-hospital mortality. We developed the Comorbidity Risk Index for Cardiogenic Shock (COMRI-CS) to capture the association between comorbidities and CS mortality. Among 6815 patients (26.5% AMI-CS, 53.6% HF-CS), 6087 (89.3%) presented with ≥1 comorbidity, and 4390 (64.4%) with ≥3 comorbidities. In-hospital mortality increased with comorbidity burden (AMI-CS: 35.4%, 39.6%, 47.1% with 1-3, 4-6, ≥7 comorbidities, respectively; HF-CS: 19.6%, 24.9%, 27.5%, respectively). A high comorbidity burden was independently associated with a 51% higher relative mortality risk in AMI-CS (odds ratio [OR] 1.51, 95% confidence interval [CI] 1.02-2.23, p = 0.037), and a more pronounced increase of 122% in HF-CS (OR 2.22, 95% CI 1.49-3.37, p < 0.001). Distinct high-risk comorbidities and combinations were identified, varying across CS subtypes. With each COMRI-CS point, in-hospital mortality increased by ~5.5%.

conclusionsIn this large real-world CS cohort, comorbidity burden was highly prevalent, varied across subtypes, and was independently associated with mortality. Integrating chronic conditions into early CS risk stratification may enhance clinical decision-making in CS management.

Indexed as

Heart FailureRegistriesShock, CardiogenicAgedComorbidityFemaleHospital MortalityHumansMaleMiddle AgedMyocardial InfarctionPrevalencePrognosisRisk AssessmentRisk FactorsAcute myocardial infarction‐related cardiogenic shockCardiogenic shockComorbiditiesComorbidity burdenHeart failure‐related cardiogenic shockMultimorbidityRisk stratification

Identifiers

PMID40956069
PMCPMC12765368

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.