This DanGer Shock secondary analysis examined coronary complexity and 180-day mortality in infarct-related cardiogenic shock; 256 patients had multivessel disease. High baseline SYNTAX scores were associated with greater mortality odds than low/intermediate scores (adjusted OR 3.12, 95% CI 1.17-8.69); residual scores independently predicted mortality. Baseline SYNTAX category did not significantly modify the microaxial pump effect (interaction p=0.31). Among 35 patients with isolated left main culprit lesions, pump support versus standard care was associated with lower mortality odds (adjusted OR 0.17, 95% CI 0.03-0.99), a hypothesis-generating finding.
Coronary complexity provided prognostic information, but no significant pump-effect interaction was detected by baseline SYNTAX category. The isolated left main subgroup signal remains exploratory.
Study limitation: Baseline SYNTAX scores were available for only 211 patients; the isolated left main analysis involved just 35 patients.
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