Effect of Invasive Hemodynamic Monitoring on the Outcomes of Cardiogenic Shock in Patients With Acute Myocardial Infarction

The role of invasive hemodynamic monitoring on the outcomes of cardiogenic shock in patients with acute myocardial infarction (AMI-CS) is controversial. We evaluated whether invasive hemodynamic monitoring improved in-hospital mortality in patients with AMI-CS. This study analyzed 1513 patients with AMI-CS presenting between 2020 and 2022. Patients were classified into 2 groups on the basis of invasive monitoring. Patients receiving invasive hemodynamic monitoring (n = 602) were more likely to present with advanced cardiogenic shock stages, cardiac arrest, bradyarrhythmias, and required more mechanical ventilation and renal support. Propensity score identified 488 matched pairs. Escalation of mechanical support was greater in patients who received noninvasive monitoring (14% vs 7%; <i>P</i> < .001). There was no difference in mortality among the matched patients (49.0% vs 49.182%, <i>P</i> > .99). Hospital stay was longer in patients who received invasive monitoring (median 7 vs 6 days; <i>P</i> = .016). In patients receiving invasive monitoring, the cardiac index, pulmonary artery capillary wedge pressure, and right atrial pressure and the use of Swan-Ganz did not predict mortality. In AMI-CS, invasive hemodynamic monitoring was not associated with improved outcomes compared with routine monitoring. These findings highlight the inconsistent evidence surrounding monitoring methods, underscoring the need for further research to inform clinical decision-making.

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Journal
Angiology
Published
2026-03-02
DOI
https://doi.org/10.1177/00033197251382436
Primary Topic
Sepsis Diagnosis and Treatment
Type
article
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article

Effect of Invasive Hemodynamic Monitoring on the Outcomes of Cardiogenic Shock in Patients With Acute Myocardial Infarction

Rishard Abdul, Mohammed A. Balghith, Mohammed Alshehri, Ahmed Abdullah Jamjoom et al.
Angiology
Sepsis Diagnosis and Treatment
article

Effect of Invasive Hemodynamic Monitoring on the Outcomes of Cardiogenic Shock in Patients With Acute Myocardial Infarction

Rishard Abdul, Mohammed A. Balghith, Mohammed Alshehri, Ahmed Abdullah Jamjoom, Shahrukh Hashmani, Mohamed Ajaz Ghani, Abdelmaksoud Elganady, Adnan Fathey Hussien, Youssef Elmahrouk, Prashanth Panduranga, Amin Daoulah, Ali Alshehri, Hassan Khan, Seraj Abualnaja, Abdelaziz Tawengi, Tarique Shahzad Chachar, Faisal Omar M. Al Nasser, Badr Mujeb Alzahrani, Alaa Aldossari, Bandar Alshehri, Sultan Mohammed Al Jarallah, Abdulrahman Almoghairi, Abdulhadi Alama, Mubarak Aldossari, Waleed Alharbi, Omar Kanbr, Islam Abdelmoneim Ahmed, Jassim Alswuaidi, Harvey Antony, Mokhtar Abdirahman Kahin, Ayman Basardah, Gladsy Selva Livingston, Hazim Rahbi, Ahmad Hersi, AbdulRahman Arabi, Mohammed A. Qutub, Abdullah Al‐Enezi, Taher Hassan, Hatem Aloui, Razan waleed W Alsofayan, Wael Almahmeed, Ahmed F. Elmahrouk, Khaled Almerri, Mohamed Mohammednabil A. Alama, Laura AlObaid, Husam A. Noor, Abeer M. Shawky, Abdulrahman M. Alqahtani, Nooraldaem Yousif, Ahmed A. Ghonim, Mohamed Alrefai, Amr A. Arafat, Said Al Maashani, Amir Lotfi, Sultan Alobaikan, Rajesh Rajan, Ibrahim A. M. Abdulhabeeb, Alsayed Ali Almarghany
article en

Abstract

The role of invasive hemodynamic monitoring on the outcomes of cardiogenic shock in patients with acute myocardial infarction (AMI-CS) is controversial. We evaluated whether invasive hemodynamic monitoring improved in-hospital mortality in patients with AMI-CS. This study analyzed 1513 patients with AMI-CS presenting between 2020 and 2022. Patients were classified into 2 groups on the basis of invasive monitoring. Patients receiving invasive hemodynamic monitoring (n = 602) were more likely to present with advanced cardiogenic shock stages, cardiac arrest, bradyarrhythmias, and required more mechanical ventilation and renal support. Propensity score identified 488 matched pairs. Escalation of mechanical support was greater in patients who received noninvasive monitoring (14% vs 7%; <i>P</i> < .001). There was no difference in mortality among the matched patients (49.0% vs 49.182%, <i>P</i> > .99). Hospital stay was longer in patients who received invasive monitoring (median 7 vs 6 days; <i>P</i> = .016). In patients receiving invasive monitoring, the cardiac index, pulmonary artery capillary wedge pressure, and right atrial pressure and the use of Swan-Ganz did not predict mortality. In AMI-CS, invasive hemodynamic monitoring was not associated with improved outcomes compared with routine monitoring. These findings highlight the inconsistent evidence surrounding monitoring methods, underscoring the need for further research to inform clinical decision-making.

Angiology
Ministry of Defence (GB), Cleveland Clinic (US), Riyadh Armed Forces Hospital (SA), Baystate Medical Center (US), Prince Sultan University (SA), Royal College of Surgeons in Ireland (IE), Al-Azhar University (EG), King Abdulaziz University (SA), King Saud bin Abdulaziz University for Health Sciences (SA), Tanta University (EG), King Faisal Specialist Hospital & Research Centre (SA), King Saud Medical City (SA), Sultan Qaboos Hospital (OM), King Fahd Medical City (SA), King Saud University (SA), King Abdulaziz Medical City (SA), Amiri Hospital (KW), King Abdullah International Medical Research Center (SA), Bugshan Hospital (SA), Chest Diseases Hospital (KW), Armed Forces Hospital (SA), Saud Al-babtain Cardiac Centre (SA), Royal Hospital (OM), King Abdulaziz Hospital (SA), King Fahad Hospital Jeddah (SA), Islamic University of Madinah (SA), Elrazi University, National Guard Health Affairs (SA), Hamad Medical Corporation (QA), King Khalid University (SA)
Good health and well-being
Openalex Percentile: Top 38%
Sepsis Diagnosis and Treatment
DOISourceOpenAlex
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