CERAMICS Registry Studies Mechanical Circulatory Support Escalation in Cardiogenic Shock

May 4, 2026—Findings from the CERAMICS registry demonstrated that early use of a mechanical circulatory support (MCS) improved outcomes in patients experiencing cardiogenic shock (CS) after experiencing a heart attack and undergoing a stenting procedure.

The data were presented as late-breaking clinical science at SCAI 2026, the Society for Cardiovascular Angiography & Interventions scientific sessions.

According to SCAI, the CERAMICS registry is designed to evaluate whether clinical outcomes were better in shock centers that have the capability of on-site MCS escalation. It is the third iteration of shock initiatives after the National Cardiogenic Shock Initiative (NCSI) and the earlier Detroit Cardiogenic Shock Initiative.

CERAMICS is a single-arm, multicenter study that enrolled 124 patients with CS across 20 hospitals that had the ability to escalate MCS.

As noted in the SCAI press release, all patients in the registry were initially treated using a shock protocol emphasizing rapid placement of an Impella MCS device (J&J Medtech), percutaneous coronary intervention (PCI), and invasive monitoring of hemodynamics.

Patients in the registry arrived at the hospital in extremely critical condition, with approximately 40% experiencing cardiac arrest, of whom 89% were experiencing ST-elevation myocardial infarction (STEMI).

SCAI reported that on average, patients received mechanical heart support within approximately 76 minutes of arriving at the hospital with a door-to-balloon time to open the blocked artery within 72 minutes. Additionally, 71% of patients survived hospital discharge, including 78% of those in SCAI stage C/D (classic/deteriorating) shock and 60% of those in stage E (extremis) shock.

The CERAMICS study included only sites with MCS escalation capabilities with devices like J&J Medtech’s Impella 5.5 and extracorporeal membrane oxygenation, explained SCAI. By contrast, the NCSI included 80 sites with varying degrees of MCS escalation and intensive care unit-level care.

When compared to the NCSI patients, patients in CERAMICS were older, were more likely to present in stage E shock, and were more likely to undergo MCS escalation (22% vs 10%; P < .01).

In the findings presented at SCAI 2026, patients in CERAMICS had similar overall survival (72% vs 72%) but had improved survival when presenting in stage E shock compared to patients in the NCSI (67% vs 50%; P = .05).

Babar Basir, DO, interventional cardiologist and Medical Director of the acute MCS program at Henry Ford Health in Detroit, Michigan, commented on the CERAMICS findings in the SCAI press release.

“Early recognition and protocol-driven care are central to improving survival in patients with shock,” stated Dr. Basir. “Most stage C and D shock patients can be successfully treated at local PCI-capable hospitals, ensuring patients get care quickly, close to home. However, the sickest patients benefit from timely transfer to centers with advanced MCS capabilities. After decades of limited progress, it’s encouraging to see this shock-care approach delivering real improvements for patients.”