SCAI Issues Multisociety-Endorsed Consensus on the Classification Stages of Cardiogenic Shock

May 20, 2019—The Society for Cardiovascular Angiography and Interventions (SCAI) announced the publication of an expert consensus statement that proposes a classification schema for cardiogenic shock that will facilitate communication in both the clinical and research settings. The document, which is endorsed by the American College of Cardiology, American Heart Association, the Society of Critical Care Medicine, and the Society of Thoracic Surgeons, is available online in SCAI’s Catheterization and Cardiovascular Interventions.

SCAI stated that the society convened a multidisciplinary writing group composed of leading experts in interventional and advanced heart failure, noninvasive cardiology, emergency medicine, critical care, and cardiac nursing to represent the team-based care of these patients.

The writing group developed a five-stage system that is defined by narrative patient descriptions, physical findings, and biochemical/hemodynamic markers, creating a new language that will facilitate rapid assessment, reassessment over time, and communication between providers including hospital systems.

According to SCAI, the new cardiogenic shock definition is intended to provide clinicians and researchers with a unified and standardized vocabulary that will translate across all settings. Additionally, the definition aims to facilitate recognition of risk for adverse outcomes and the potential benefit from various interventions and prognosis with the goal of reducing mortality on both an individual and national scale.

Srihari S. Naidu, MD, chair of the writing group, commented in the announcement, “The main areas we may have failed in the fight to improve mortality in cardiogenic shock is, quite simply, not speaking the same language when describing these patients. Without that, we can’t even begin to understand these patients, how sick they are, what might work and what does not work. This is the most important first step and it is important to use this classification system to reset our understanding of cardiogenic shock and restart the trials very much needed in this space.”