Please select your specialty / training:
* must provide value
Cardiothoracic Surgery Interventional Cardiology Heart Failure / Transplant Cardiology Critical Care Cardiology General Cardiology
REQUIRED: Select your specialty
1-5 years 6-10 years 11-20 years 21-30 years >30 years
(Years after completion of clinical training)
Please select your practice setting:
* must provide value
Academic Medical Center University Affiliated Hospital Center Private Hospital Public Hospital
REQUIRED: Select your practice setting
Please provide your hospital affiliation:
Hospital / medical center name
Please provide the location of your hospital (city / country):
Hospital city / country
May we contact you if we have follow-up queries based on your responses?
Yes No
Please provide your e-mail address:
Please provide your telephone number:
Is there an advanced heart failure mechanical circulatory support program at your institution?
Yes No
Mechanical circulatory support program director name:
Mechanical circulatory support program director e-mail address:
Mechanical circulatory support program director telephone number:
Is there a heart failure sub-specialist at your institution?
Yes No
Heart failure program director name:
Heart failure program director e-mail address:
Heart failure program director telephone number:
How many patients with STEMI does your center treat each year?
< 50 51-100 101-200 201-300 300+ Uncertain
Estimated number of patients (n=)
How many patients with MI (STEMI or NSTEMI) complicated by cardiogenic shock does your center treat each year?
< 10 11-25 26-50 51-100 100+ Uncertain
Estimated number of patients (n=)
Of these, how many patients with MI and cardiogenic shock have multi-vessel CAD?
< 10 11-25 26-50 51-100 100+ Uncertain
Estimated number of patients (n=)
What is the standard approach to revascularization in a patient with acute MI with cardiogenic shock and multivessel disease at your center?
Medical management only Single vessel PCI of infarct-related artery (IRA) Single vessel PCI of IRA with staged PCI of non-culprit severe disease Multi-vessel PCI of all lesions during the index procedure Multivessel CABG
What revascularization strategy do you believe is associated with the best outcomes in AMI with cardiogenic shock and multivessel CAD?
Medical therapy; no revascularization PCI CABG Initial PCI + Staged CABG Uncertain / No data
In patients with MI, cardiogenic shock, and multivessel disease undergoing revascularization by PCI, what is the preferred method of mechanical circulatory support at your center?
IABP Impella Tandem Heart ECMO Centrimag / BiVAD Other
You selected "Other". Please specify the preferred method of MCS at your center:
Is there a minimum lactate threshold for which you would consider placement of a mechanical circulatory support device (other than IABP)?
Yes No
What is the minimum lactate threshold for mechanical circulatory support (other than IABP)?
2-4 mmol/L 4-10 mmol/L 10-20 mmol/L >20 mmol/L Uncertain
Note: Lactate upper limit of normal is typically between 1.8 and 2.5 mmol/L
In patients with residual cardiogenic shock after PCI, which of the following interventions do you most commonly use for circulatory / hemodynamic support? (Check all that apply)
Select all that apply
Does your center have an algorithm for the stepwise escalation of hemodynamic / circulatory support post-PCI?
Yes
No
Please describe this algorithm:
How many cardiac surgeons operate at your hospital center?
0-2 3-5 >5 Uncertain
How many CABG surgeries are performed at your hospital center each year?
0-50 51-100 101-250 251-500 >500 Uncertain
If you were to refer a patient with AMI complicated by cardiogenic shock with multivessel CAD for CABG (without performing balloon angioplasty of the infarct vessel at the time of angiography), what length of time delay to the OR would you consider to be acceptable?
< 30 minutes < 60 minutes < 90 minutes < 120 minutes < 180 minutes < 240 minutes >= 240 minutes Uncertain
Minutes to CABG
Do you think your center could achieve this target?
Yes No
Why would your center have difficulty achieving this target time to CABG?
If you were to refer a patient with AMI complicated by cardiogenic shock with multivessel CAD for CABG, after BALLOON ANGIOPLASTY of the INFARCT RELATED ARTERY was performed to re-establish coronary flow prior to surgery, what length of time delay to the OR would you consider to be acceptable?
< 30 minutes < 60 minutes < 90 minutes < 120 minutes < 180 minutes < 240 minutes >= 240 minutes Uncertain
Minutes to CABG
Do you think your center could achieve this target?
Yes No
Why would your center have difficulty achieving this target time to CABG?
In patients with MI, cardiogenic shock, and multivessel disease undergoing revascularization by CABG, what is the preferred method of mechanical circulatory support at your center?
IABP Impella Tandem Heart ECMO Centrimag / BiVAD Other
You selected "Other". Please specify the preferred method of MCS at your center:
Is there a minimum lactate threshold for which you would consider placement of a mechanical circulatory support device (other than IABP)?
Yes No
What is the minimum lactate threshold for which you would consider placement of mechanical circulatory support (other than IABP)?
2-4 mmol/L 4-10 mmol/L 10-20 mmol/L >20 mmol/L Uncertain
Note: Lactate upper limit of normal is typically between 1.8 and 2.5 mmol/L
In patients with residual cardiogenic shock after CABG, which of the following interventions do you most commonly use for circulatory / hemodynamic support? (Check all that apply)
Select all that apply
Does your center have an algorithm for the stepwise escalation of hemodynamic / circulatory support after CABG?
Yes
No
Please describe this algorithm:
Would you be willing to enroll patients with AMI with multivessel CAD and cardiogenic shock into a RANDOMIZED trial of: IRA-PCI (with or without staged complete revascularization) versus emergent multivessel CABG with intent to perform complete revascularization?
Yes No
What are the major barriers to participation?
Select all that apply
What aspects of the trial design would affect your willingness to participate / enroll patients? (Optional)
Please provide any additional thoughts, concerns, or suggestions: (Optional)
May we include your responses to this survey in a prospective observational research study on contemporary approaches to management of cardiogenic shock?
* must provide value
Yes
No
The purpose of this research study is to determine the contemporary clinical management of patients with myocardial infarction, multi-vessel coronary artery disease, and cardiogenic shock. We are asking you to take part in this research study because you may care for patients with this condition. Participating in this study requires approximately 10 minutes of time and involves completing a short electronic survey. You are free to skip any questions that you prefer not to answer. No follow-up is required. There may be some risk from being in this study. You may experience frustration that is often experienced when completing surveys. However, such risks are not viewed as being in excess of "minimal risk". There are no other foreseeable risks to participation in this study. You will not benefit personally from participating in this study. However, we hope that the results of the survey may provide a better understanding of current practice patterns in the management of cardiogenic shock. Participation in this study is completely voluntary and you may choose to not participate in this research study, even if you have already provided answers to the survey questions. You will not be paid for being in this study. There will be no cost to you for being in this research study. Any identifiable information you choose to provide will not be used for the purposes of the research study. If you decide to participate, you are free to leave the study at any time. To withdraw your permission, send a written notice to the principal investigator for the study: Dr. Nathaniel Smilowitz (Division of Cardiology, Department of Medicine, 530 First Avenue, New York, NY, USA 10016. Tel: 212-263-5656).
I acknowledge I have read the above statement and I wish to participate in the research study.
I do not wish to participate in the research study.
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