What is the clinical evidence from this study?

Study design: Observational. Population: ST-segment-elevation myocardial infarction-cardiogenic shock (STEMI-CS) (n=4300000). Intervention: Admission year 2017 vs. Admission year 2000. Primary outcome: In-hospital mortality (aOR 0.29, 95% CI 0.28-0.31, p=<0.001).

December 3, 2021

Cardiogenic Shock Complicating ST-Segment Elevation Myocardial Infarction: An 18-Year Analysis of Temporal Trends, Epidemiology, Management, and Outcomes

Q: What are the key findings of this study?

Between 2000 and 2017, the incidence of cardiogenic shock in STEMI increased from 5.8% to 13.0%, while in-hospital mortality decreased from 49.6% to 32.7% (aOR 0.29; 95% CI 0.28-0.31; P<0.001).

Resultado clave

Between 2000 and 2017, the incidence of cardiogenic shock in STEMI increased from 5.8% to 13.0%, while in-hospital mortality decreased from 49.6% to 32.7% (aOR 0.29; 95% CI 0.28-0.31; P<0.001).

Diseño del estudio

Tipo

Observational (n=4,300,000)

Multicéntrico

Sí

PICO estructurado

Población

368,820 adult (>18 years) admissions with ST-segment-elevation myocardial infarction complicated by cardiogenic shock (STEMI-CS) out of ~4.3 million STEMI admissions in the United States (National Inpatient Sample 2000-2017).

Resultado

Temporal trends, acute organ failure, cardiac procedures, in-hospital mortality, hospitalization costs, and length of stayhard clinical

Between 2000 and 2017 in the US, the incidence of cardiogenic shock complicating STEMI increased 2.5-fold, but in-hospital mortality significantly decreased alongside increased use of coronary angiography and PCI.

Resultado numérico

Estimación del efecto: aOR 0.29 (95% CI 0.28-0.31)

Tasa de eventos absoluta: 32.7% vs 49.6%

valor p: p=<0.001

Resumen

BACKGROUND: There are limited data on the temporal trends, incidence, and outcomes of ST-segment-elevation myocardial infarction-cardiogenic shock (STEMI-CS). METHODS: Adult (>18 years) STEMI-CS admissions were identified using the National Inpatient Sample (2000-2017) and classified by tertiles of admission year (2000-2005, 2006-2011, 2012-2017). Outcomes of interest included temporal trends, acute organ failure, cardiac procedures, in-hospital mortality, hospitalization costs, and length of stay. RESULTS: In ∼4. 3 million STEMI admissions, CS was noted in 368, 820 (8. 5%). STEMI-CS incidence increased from 5. 8% in 2000 to 13. 0% in 2017 (patient and hospital characteristics adjusted odds ratio aOR 2. 45 95% confidence interval CI 2. 40-2. 49; P 0. 05). CONCLUSIONS: In the United States, incidence of CS in STEMI has increased 2. 5-fold between 2000 and 2017, while in-hospital mortality has decreased during the study period. Use of coronary angiography and PCI increased during the study period.

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Cite This Study

Vallabhajosyula et al. (Fri,) conducted a observational in ST-segment-elevation myocardial infarction-cardiogenic shock (STEMI-CS) (n=4,300,000). Admission year 2017 vs. Admission year 2000 was evaluated on In-hospital mortality (aOR 0.29, 95% CI 0.28-0.31, p=<0.001). Between 2000 and 2017, the incidence of cardiogenic shock in STEMI increased from 5.8% to 13.0%, while in-hospital mortality decreased from 49.6% to 32.7% (aOR 0.29; 95% CI 0.28-0.31; P<0.001).

synapsesocial.com/papers/6a07b4a044ff8ad339f69b99 https://doi.org/https://doi.org/10.1097/shk.0000000000001895

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