Journal of the Society for Cardiovascular Angiography & Interventions · 2026
Building a Multidisciplinary Cardiogenic Shock Program in Latin America: Outcomes From the TecSalud Program.
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Jimenez-Franco Vicente, Rodriguez-Rivera Jahir, Quevedo-Salazar Renata, Salinas-Casanova Jose A, Flores-Zertuche Monica, Gocher-Janet Cecilia, Ibarrola-Peña Juan Carlos, Jerjes-Sanchez Carlos, Gomez-Gutierrez Rene D, Quezada-Valenzuela Guillermo, Peña Erasmo de la, Torre-Amione Guillermo
Аннотация
BACKGROUND: Cardiogenic shock (CS) remains associated with high mortality despite modern reperfusion and mechanical circulatory support. Multidisciplinary "CS teams" have demonstrated improved outcomes; however, data from low- and middle-income countries are scarce. This study describes the experience and outcomes following the implementation of a dedicated CS team at a tertiary hospital in Mexico.
METHODS: We conducted a retrospective, single-center cohort study including consecutive adults with CS admitted to TecSalud between January 2021 and August 2025. The multidisciplinary CS team was established in August 2022. Patients were divided into 2 cohorts: pre-team (January 2021 to July 2022) and post-team (August 2022 to August 2025). The primary end point was 30-day all-cause mortality. Mortality rates were compared using the Fisher exact test.
RESULTS: A total of 67 patients were included (27 preteam, 40 postteam). Among the postteam cohort, the mean age was 63 ± 15.2 years, and 73% were male. The leading etiology was acute myocardial infarction-related CS (67.5%), followed by decompensated heart failure (20%). The median hospital stay was 11.5 days (0-122), and the average ICU stay was 7 days (1-105). Most patients presented in the Society for Cardiovascular Angiography & Interventions (SCAI) SHOCK stage E (33%), 80% required mechanical circulatory support, and 18% underwent extracorporeal cardiopulmonary resuscitation. Implementation of the CS team was associated with a reduction in 30-day mortality from 63% to 25%.
CONCLUSIONS: The implementation of a multidisciplinary CS team at a tertiary center in Mexico was associated with a substantial reduction in 30-day mortality and improved care coordination. These findings support the feasibility and effectiveness of structured CS programs in complex health care environments.
METHODS: We conducted a retrospective, single-center cohort study including consecutive adults with CS admitted to TecSalud between January 2021 and August 2025. The multidisciplinary CS team was established in August 2022. Patients were divided into 2 cohorts: pre-team (January 2021 to July 2022) and post-team (August 2022 to August 2025). The primary end point was 30-day all-cause mortality. Mortality rates were compared using the Fisher exact test.
RESULTS: A total of 67 patients were included (27 preteam, 40 postteam). Among the postteam cohort, the mean age was 63 ± 15.2 years, and 73% were male. The leading etiology was acute myocardial infarction-related CS (67.5%), followed by decompensated heart failure (20%). The median hospital stay was 11.5 days (0-122), and the average ICU stay was 7 days (1-105). Most patients presented in the Society for Cardiovascular Angiography & Interventions (SCAI) SHOCK stage E (33%), 80% required mechanical circulatory support, and 18% underwent extracorporeal cardiopulmonary resuscitation. Implementation of the CS team was associated with a reduction in 30-day mortality from 63% to 25%.
CONCLUSIONS: The implementation of a multidisciplinary CS team at a tertiary center in Mexico was associated with a substantial reduction in 30-day mortality and improved care coordination. These findings support the feasibility and effectiveness of structured CS programs in complex health care environments.