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 the IQ database and cVAD Study, 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 May 2019, 171 patients with AMI cardiogenic shock from 35 NCSI sites treated using Impella best practices have demonstrated 72% survival with 98% native heart recovery at discharge.3

References:

  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. Basir, M. B., et al. (2019). "Improved Outcomes Associated with the use of Shock Protocols: Updates from the National Cardiogenic Shock Initiative." Catheter Cardiovasc Interv

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