Right Heart Catheterization improves outcomes of cardiogenic shock: Study

The usefulness of right heart catheterization Right Heart Catheterization (RHC) has long been debated.

A group of researchers from U.S.A. conducted a study to study the real‐world impact of the use of Right Heart Catheterization (RHC) in cardiogenic shock.

In the Nationwide Readmissions Database using International Classification of Diseases, Tenth Revision (ICD‐10), we identified 236 156 patient hospitalizations with cardiogenic shock between 2016 and 2017.

The authors sought to evaluate the impact of Right Heart Catheterization (RHC) during index hospitalization on management strategies, complications, and outcomes as well as on 30‐day readmission rate.

A total 25 840 patients (9.6%) received Right Heart Catheterization (RHC) on index admission.

The results of the study are as follows:

· The Right Heart Catheterization (RHC) group had significantly more comorbidities compared with the non‐ Right Heart Catheterization (RHC) group.

· During the index admission, the Right Heart Catheterization (RHC) group had lower death and stroke rates.

· Thirty‐day readmission rates and death on readmission was also lower in the RHC group.

· After adjustment, Right Heart Catheterization (RHC) was associated with lower index admission, mortality, lower stroke rate, lower 30‐day readmission, and higher left ventricular assist device implantations/orthotopic heart transplants during rehospitalization.

· Results were not meaningfully different after excluding patients with cardiac arrest.

Thus, the researchers concluded that Right Heart Catheterization (RHC) use in cardiogenic shock is associated with improved outcomes and increased use of downstream advanced heart failure therapies. Further blinded randomized studies are required to confirm our findings.

Reference:

A study titled, "Right Heart Catheterization in Cardiogenic Shock Is Associated with Improved Outcomes: Insights From the Nationwide Readmissions Database" by Ranka S et. al published in the Journal of the American Heart Association.

DOI: doi/10.1161/JAHA.120.019843