MONTREAL–Findings from the Can Escalation Reduce Acute Myocardial Infarction Mortality in Cardiogenic Shock (CERAMICS) registry demonstrate that early use of a small heart pump improves outcomes in patients experiencing a severe form of heart failure called cardiogenic shock after suffering from a heart attack and undergoing a stenting procedure. Researchers presented this late-breaking data today at the Society for Cardiovascular Angiography & Interventions (SCAI) 2026 Scientific Sessions & Canadian Association of Interventional Cardiology (CAIC-ACCI) Summit.

Cardiogenic shock (CS) happens when the heart suddenly cannot pump enough blood to the body and is a leading cause of in-hospital mortality following an acute myocardial infarction (AMI, or a heart attack). Standard approaches typically include medications, early revascularization with PCI, and mechanical circulatory support devices (MCS). The CERAMICS trial, as a part of the National Cardiogenic Shock Initiative (NCSI), was designed to evaluate whether clinical outcomes were better in shock centers that have the capability of on-site MCS escalation.

The CERAMICS study is a single-arm, multi-center study that enrolled 124 patients with CS across 20 hospitals, all of whom had the ability to escalate MCS. All patients were initially treated using a shock protocol emphasizing rapid placement of Impella™ (J&J Medtech), percutaneous coronary intervention (PCI), and invasive monitoring of hemodynamics. 

The study found that patients arrived at the hospital in extremely critical condition, with about 40% experiencing cardiac arrest. Nearly nine in ten patients (89%) were having a severe type of heart attack known as ST-elevation myocardial infarction (STEMI). On average, patients received mechanical heart support within about 76 minutes of arriving at the hospital and had their blocked artery opened within 72 minutes (door-to-balloon time). Despite the severity of illness, most patients (71%) survived hospital discharge, including 78% of those in the SCAI stage C/D (classic/deteriorating) shock and 60% of those in the most severe stage E shock (Extremis). 

The CERAMICS registry was the third iteration of the shock initiative, after the Detroit and National Cardiogenic Shock Initiatives. Whereas the National Cardiogenic Shock Initiative included 80 sites with varying degrees of MCS escalation and ICU-level care, the CERAMICS study included only sites with MCS escalation capabilities with devices like Impella 5.5 (J&J Medtech) and extracorporeal membrane oxygenation (ECMO). When compared to NCSI, patients in CERAMICS were older, more likely to present in Stage E Shock, and were more likely to undergo MCS-escalation (22% vs 10%, p<0.01). When compared to NCSI, patients in CERAMICS had similar overall survival (72% vs 72%) but had improved survival when presenting in Stage E shock (67% vs 50%, p=0.05). 

“The results of our research reinforce that early recognition and protocol-driven shock management are important methods of improving outcomes in shock patients,” said Babar Basir, DO, FSCAI, interventional cardiologist and medical director of the acute MCS program at Henry Ford Health System in Detroit. “What is especially encouraging is seeing that most shock patients (stage C/D shock) are best treated in local PCI-capable hospitals, ensuring patients get care quickly, close to home. However, the sickest patients do benefit from being treated at sites with MCS escalation capabilities, and this can be done by direct admission or transfer after initial stabilization and revascularization. I am proud of the efforts that have been made by the shock initiative after decades with limited progress in treating cardiogenic shock. It is promising to see evidence that these approaches are making meaningful differences for our patients.”

Researchers note that the next phase of the cardiogenic shock initiative is to expand to global sites that are looking to create cardiogenic shock systems of care.

Session Details:

• Can Escalation Reduce Acute Myocardial Infarction Mortality in Cardiogenic Shock (CERAMICS)
  • Thursday, April 23; 2:20-2:28 PM ET
  • Palais des Congrès de Montréal, 511def (5th Level)

Media Contact

Gavin Stern 

[email protected], 202-644-8561

About SCAI 2026 Scientific Sessions

The SCAI Scientific Sessions annual meeting convenes nearly 2,000 of the world’s premier clinicians, scientists, researchers, and innovators in the field of interventional cardiology and endovascular medicine. With 500+ faculty and hundreds of abstracts, experts in the field work together to share the latest clinical data, procedural guidance, and advanced expertise. Highlights include live cases, featured clinical research, new SCAI clinical documents, case-based learning, and keynote speakers. For more information, visit SCAI 2026 Scientific Sessions & CAIC-ACCI Summit.

About the Society for Cardiovascular Angiography & Interventions (SCAI) 

The Society for Cardiovascular Angiography & Interventions, established in 1978, stands as the primary nonprofit medical society dedicated to representing invasive and interventional cardiology. SCAI's mission is to guide the global interventional cardiovascular community by fostering education, advocacy, research, and upholding standards for quality patient care. For more than 40 years, SCAI has exemplified professional excellence and innovation worldwide, cultivating a reputable community of over 5,000 members committed to advancing medical science and providing life-saving care for individuals, both adults and children, affected by cardiovascular disease.  For more information, visit www.scai.org.

About Canadian Association of Interventional Cardiology/Association Canadienne de cardiologie d’intervention (CAIC-ACCI)

The Canadian Association of Interventional Cardiology / Association Canadienne de cardiologie d’intervention (CAIC-ACCI) is a national body representing 307 interventional cardiologists across Canada. Dedicated to advancing excellence in cardiovascular care, CAIC-ACCI plays a central role in supporting its members through high-quality educational events, fostering professional growth, and promoting innovation in clinical practice. The organization is also deeply committed to the training and development of interventional cardiology Fellows, helping to shape the next generation of specialists. For more information, visit www.caic-acci.org.