Babar Basir: Predictors of Outcomes From NCSI

Babar Basir, D.O., highlights trends and opportunities to improve outcomes using data from the National Cardiogenic Shock Initiative (NCSI) study. He explains that you can predict how patients are going to do if you look at their hemodynamics, particular cardiac power output (CPO), as soon as you finish with the index procedure in the cath lab and also look at the number of vasopressors and inotropes the patients are on at that time. “Patients who have a cardiac power output greater than 0.6 watts, who are on a moderate dose of one pressor or less, tend to do extremely well with survival typically higher than 70%,” he states, emphasizing that you should be able to take those patients back to the ICU, wean off their inotropes and vasopressors and get a good outcome.

In contrast, Dr. Basir explains that patients who are left with poor CPO, or who are on multiple vasoactive agents, require more time and attention in the cath lab to understand the hemodynamic trends. “So we recommend getting serial hemodynamics every 15 minutes to get an idea if they’re getting better or worse. And in particular, we want to pay attention to the identification of right heart failure. Because I think it’s a key principle that we really haven’t discussed enough when we started the Cardiogenic Shock Initiative and I think it’s a really important way to improve survival.”