Right heart catherization (RHC) in patients with cardiogenic shock (CS) may result in better outcomes and greater use of downstream advanced heart failure therapies, according to new data published in the Journal of the American Heart Association.
“This large real‐world retrospective study of patients with cardiogenic shock demonstrates that right heart catheterization is associated with improved in‐hospital survival and reduced rehospitalizations,” wrote lead author Sagar Ranka, MD, with the department of cardiovascular medicine, The University of Kansas Health System, and colleagues. “Moreover, though the use of right heart catheterization across the United States is infrequent, the procedure improves downstream use of life‐saving advanced heart failure therapies.”
Researchers analyzed 236,156 patients who were hospitalized with CS between 2016 and 2017. Of that group only 25,840 underwent RHC upon admission.
All data came from the Nationwide Readmissions Database using International Classification of Diseases, Tenth Revision.
The authors found that compared with their counterparts, patients who underwent RHC tended to be younger, aged 61.6 years versus 67.3 years. Sixty-eight percent of patients were men.
Patients who underwent RHC had a higher morbidity such as a history of congestive heart failure, arrhythmias, valvular heart disease, peripheral vascular disease, and hypertension.
The authors also found that invasive therapies during admission were more prevalent in patients undergoing RHC including temporary mechanical circulatory support (MCS), percutaneous left ventricular assist device, extracorporeal life support, and left heart catheterization.
In addition, percutaneous coronary intervention wasn’t as prevalent, while the utilization of advance surgical heart failure therapies was substantially elevated in the RHC group.
“In patients with cardiogenic shock, hemodynamic profiling using right heart catheterization should be considered to tailor therapies and optimize outcomes. Additional blinded studies are needed to investigate the clinical implications of hemodynamic‐driven treatment strategies in these patients,” the authors wrote.
Read the full study here.