What is NCSI?

November 5, 2018


National Cardiogenic Shock Initiative (NCSI) is a national, multicenter initiative aimed at improving mortality in patients with cardiogenic shock.1 Based on the consistent finding of good survival outcomes with early hemodynamic support with Impella devices from real world registries such as cVAD or IQ, a best practices algorithm for the treatment of patients with AMICS was established. The NCSI is based on adopting the best practices algorithm focused on identifying shock early and unloading using Impella devices before PCI, reducing use of inotropes, and the use of invasive hemodynamic monitoring to aid in escalation and weaning.


In 2016, 4 hospital systems in Detroit participated in the CSI by treating patients with cardiogenic shock based on the best practices algorithm. The data collected from the pilot Detroit Cardiogenic Shock Initiative (DCSI) showed improvement in survival rates from 50% to 76%.2 As of September 2018, 104 patients with AMICS have been treated at 56 NCSI sites with survival to hospital discharge in 77%.3


  1. O’Neill W. National Cardiogenic Shock Initiative (NCSI). 2016; https://www.henryford.com/cardiogenicshock. Accessed 12 Sep, 2018.
  2. Basir MB, Schreiber T, Dixon S, et al. Feasibility of early mechanical circulatory support in acute myocardial infarction complicated by cardiogenic shock: The Detroit cardiogenic shock initiative. Catheter Cardiovasc Interv. 2017.
  3. Rab T, Ratanapo S, Kern KB, et al. Cardiac Shock Care Centers. J Am Coll of Cardiol 2018, 72 (16) 1972-1980.