In patients with AMI-related cardiogenic shock, in-hospital mortality was 47.5%, with non-STEMI, high lactates, older age, and no antibiotic need predicting death.
In a contemporary Polish registry, AMI-related cardiogenic shock remains associated with a high in-hospital mortality rate of 47.5%, with older age, NSTEMI presentation, and elevated lactates serving as independent predictors of death.
Tasa de eventos absoluta: 0% vs 0%
Abstract Aims Cardiogenic shock (CS) represents an ominous complication of acute myocardial infarction (AMI) with mortality rate exceeding 50%. The aim of the study was to evaluate current management, outcomes and risk factors of mortality of AMI-related CS. Methods This snap-shot registry evaluated all patients with AMI-related CS hospitalized in 9 cardiology centers across Poland between January and December 2023. The inclusion criteria involved CS defined as prolonged (20 min) hypotension with signs of peripheral hypoperfusion and diagnosis of AMI qualified for urgent coronary angiography. The primary endpoint was in-hospital mortality. Results The study comprised 141 patients (72.3% men; mean age was 69.2 14 years). The majority of patients were in Society for Cardiovascular Angiography and Interventions class C (n=71,50.4%), followed by class D (n=46,32.6%) and class E (n=24,17.0%). Percutaneous coronary intervention was performed in 133 cases (94.3%) while coronary artery bypass graft in 5 (3.5%). Mechanical circulatory support (MCS) was used in 33 patients (23.4%) and involved intra-aortic balloon pump (n=26,18.4%), Impella CP (n=6,4.3%), Impella 5.5 (n=2,1.4%) and veno-arterial extracorporeal membrane oxygenation (n=10,7.1%). In-hospital mortality rate was 47.5% (n=67), while 30-day mortality was 51.8% (n=73). Cox proportional hazards model showed that non-ST-elevation AMI (HR=2.38,95%CI:1.19-4.75), lack of the need for antibiotic therapy (HR=2.61, 95%CI:1.26-5.39), elevated lactates (unit HR per 1 mmol/l=1.19, 95%CI:1.11-1.27) and age (unit HR=1.05; 95%CI:1.02-1.07) were independent predictors of in-hospital mortality. Conclusions Short-term mortality rate of AMI-related CS still amounts to 50%, which advocates in favor of further research evaluating the true role of MCS in this population.
Wybraniec et al. (Wed,) reported a other. In patients with AMI-related cardiogenic shock, in-hospital mortality was 47.5%, with non-STEMI, high lactates, older age, and no antibiotic need predicting death.