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Building a Multidisciplinary Cardiogenic Shock Program in Latin America: Outcomes From the TecSalud Program

Vicente Jimenez-Franco, Jahir Rodriguez-Rivera, Renata Quevedo-Salazar, Jose A. Salinas-Casanova, Monica Flores-Zertuche, Cecilia Gocher-Janet, Juan Carlos Ibarrola-Peña, Carlos Jerjes-Sanchez, Rene D. Gomez-Gutierrez, Guillermo Quezada-Valenzuela, Erasmo de la Peña, Guillermo Torre-Amione

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
Article number105508
JournalJournal of the Society for Cardiovascular Angiography and Interventions
DOIs
StateE-pub ahead of print - Jul 7 2026

Keywords

  • cardiogenic shock
  • low- and middle-income countries
  • mechanical circulatory support
  • multidisciplinary team
  • program development

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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