One-Year Survival Among Patients With Acute Myocardial Infarction Complicated by Cardiogenic Shock, and its Relation to Early Revascularization
Key result
Early revascularization in 30-day AMI shock survivors is linked to ~40% lower 1-year mortality.
- OR 0.6
- 95% CI 0.4-0.9
- P=0.007
- n=37,654
Why the study?
Does coronary revascularization within 30 days improve 1-year survival in 30-day survivors of acute myocardial infarction complicated by cardiogenic shock?
Population
37,654 30-day survivors of acute myocardial infarction from the GUSTO-I trial, including 36,333 without…
Comparison
Coronary revascularization within 30 days vs No coronary revascularization within 30 days
Design
Cohort
Follow-up
1 year
Authors
Discussion
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Implication
May support revascularization in AMI shock survivors; leaves open whether RCTs confirm survival benefit.
Study Design
Type
Cohort (n=37,654)
Multicenter
Yes
Structured PICO
Does coronary revascularization within 30 days improve 1-year survival in 30-day survivors of acute myocardial infarction complicated by cardiogenic shock?
P
Population
37,654 30-day survivors of acute myocardial infarction (1,321 with cardiogenic shock) from the GUSTO-I trial, followed for 1 year.
E
Exposure
Coronary revascularization within 30 days
C
Comparator
No coronary revascularization within 30 days
O
Outcome
1-year survival/mortalityhard clinical
Main Result
Odds Ratio: 0.6 (95% CI 0.4–0.9)
Absolute Event Rate: 91.7% vs 85.3%
p-value: p=0.007
In 30-day survivors of acute myocardial infarction complicated by cardiogenic shock, early revascularization is associated with significantly improved 1-year survival.
Cite This Study
Berger et al. (1999) conducted a cohort in Acute myocardial infarction complicated by cardiogenic shock (n=37,654). Early revascularization (within 30 days) vs. No revascularization within 30 days was evaluated on 1-year survival (OR 0.6, 95% CI 0.4-0.9, p=0.007). Early revascularization within 30 days in AMI patients with cardiogenic shock who survived to 30 days was associated with reduced 1-year mortality (OR 0.6; 95% CI 0.4-0.9; P=0.007).