title: Impact of Pulmonary Artery Catheter Use on Short- and Long-Term Mortality in Patients with Cardiogenic Shock.
abstract: OBJECTIVE
  The impact of pulmonary artery catheterization (PAC) on survival in patients with cardiogenic shock (CS) is not well established. This study aimed to assess whether Swan-Ganz catheter monitoring is related to short- and long-term mortality in patients with CS.
  
  
  METHODS
  One hundred and twenty-nine consecutive patients with a first admission for CS were prospectively enrolled in a single-center registry between December 2005 and May 2009, and were subsequently followed up over 5.3 years.
  
  
  RESULTS
  PAC was used in 64% of all patients with a mean age of 68 years (65% men). After adjustment for age, gender and the presence of CS upon admission, PAC was associated with lower short-term mortality [hazard ratio (HR) = 0.55, 95% confidence interval (CI) 0.35-0.86, p = 0.008] as well as lower mortality rates in the long-term follow-up (HR = 0.63, 95% CI 0.41-0.97, p = 0.035). In a subgroup analysis, the use of PAC was associated with reduced mortality in patients without acute coronary syndrome (ACS), i.e. 49% in the Swan-Ganz group vs. 82% (p = 0.010), but there was no difference within the ACS group.
  
  
  CONCLUSIONS
  The use of PAC in patients with CS was associated with lower short- and long-term mortality rates after adjustment for age, gender and the presence of shock upon admission. This benefit was only significant in those patients without ACS.
authors.affiliation: Cardiology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Xavier
authors.initials: X
authors.lastname: Rossello
authors.forename: Montserrat
authors.initials: M
authors.lastname: Vila
authors.forename: Mercedes
authors.initials: M
authors.lastname: Rivas-Lasarte
authors.forename: Andreu
authors.initials: A
authors.lastname: Ferrero-Gregori
authors.forename: Jordi
authors.initials: J
authors.lastname: Sans-Roselló
authors.forename: Albert
authors.initials: A
authors.lastname: Duran-Cambra
authors.forename: Alessandro
authors.initials: A
authors.lastname: Sionis
mesh_terms: D054058:Acute Coronary Syndrome / Q000150:complications*; D000368:Aged; D002407:Catheterization, Swan-Ganz; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012770:Shock, Cardiogenic / Q000150:complications / Q000401:mortality* / Q000628:therapy*; D015996:Survival Rate