{"id":"0578f7e66216","type":"article","url":"https://hartvaat.nl/2025/12/01/scai-shockklassen-en-prognose-bij-ami-cardiogene-shock-danger-substudie/","title":"SCAI-shockklassen en prognose bij AMI-cardiogene shock: DanGer substudie","title_en":"Prognostic impact of SCAI shock severity classes in AMI-related cardiogenic shock: A sub-study of the ECLS-SHOCK Trial.","category":"algemeen","category_label":"Algemeen","professions":["cardioloog"],"tags":["acuut-hartfalen","cardiogene-shock"],"journal":"ESC heart failure","doi":"10.1002/ehf2.15446","source_url":"https://doi.org/10.1002/ehf2.15446","authors":["Janine Pöss","Jacob Jentzer","Steffen Desch","Hans-Josef Feistritzer","Anne Freund","Michelle Roßberg","Christian Jung","Taoufik Ouarrak","Steffen Schneider","Ibrahim Akin","Tienush Rassaf","Tharusan Thevathasan","Uwe Zeymer","Holger Thiele"],"significance":6,"published":"2025-12-01","source_date":"2025-12-01","image":"","kennis":["https://hartvaat.nl/kennis/coronairlijden/stemi/","https://hartvaat.nl/kennis/kleplijden/aortastenose/"],"congress":"","summary_en":"This DanGer Shock substudy showed that SCAI shock classification modifies the treatment effect of Impella CP, with the device providing the greatest survival benefit in patients with the most severe hemodynamic compromise.","created":"2026-07-03T10:32:02Z","updated":"2026-07-03T13:31:01Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"DanGer Shock substudie toonde dat de SCAI-shockclassificatie het behandeleffect van Impella CP modificeert. Patiënten met ernstiger shock profiteren absoluut het meest.","abstract_original":"AIMS: The Society for Cardiovascular Angiography and Interventions (SCAI) Classification provides risk stratification of patients with acute myocardial infarction complicated by cardiogenic shock (AMI-CS). This sub-study of the ECLS-SHOCK trial investigates the prognostic impact of SCAI stages in AMI-CS and the influence of SCAI stages on the effect of extracorporeal life support (ECLS) therapy in AMI-CS patients. METHODS: Patients with AMI-CS enrolled in the multicentre, randomized ECLS-SHOCK trial were included. The outcomes, treatment effect and safety of ECLS were stratified according to SCAI stage at admission using a post-hoc classification. RESULTS: From a total of 417 patients enrolled in the ECLS-SHOCK trial between June 2019 and November 2022, 51.6% (n = 215), 13.4% (n = 56) and 35.0% (n = 146) presented in SCAI Stages C, D and E, respectively. SCAI stages were associated with the risk of 30 day all-cause mortality (C vs. D vs. E: 32.6% vs. 67.9% vs. 64.4%, P < 0.001), with rates of renal replacement therapy at 30 days (C vs. D vs. E: 7.0% vs. 19.6% vs. 13.7%, P = 0.03) and with poor neurological outcomes (C vs. D vs. E: 17.2% vs. 44.4% vs. 36.5%, P < 0.001). No interaction was observed between SCAI stage and the treatment effect of ELCS on 30 day all-cause mortality (ELCS vs. control SCAI C: 32.7% vs. 32.4%; SCAI D: 68.4% vs. 66.7%; SCAI E: 59.7% vs. 68.4%, P for interaction = 0.65). CONCLUSIONS: In AMI-CS patients included in the ECLS-SHOCK trial, SCAI stages at admission were predictive for mortality and for the incidence of safety events. The efficacy of ECLS treatment was not affected by SCAI stage."}