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June 1, 2023Circulation Cardiovascular InterventionsOpen Access

Between 60 and 90 minutes, for each 10-minute increase in FMC-to-device time, absolute mortality for patients with cardiogenic shock increased by 4% to 7%, whereas for patients without cardiogenic shock, it increased by <0.5%.

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Why the study?

Mortality remains high in STEMI complicated by cardiogenic shock despite early reperfusion, motivating an assessment of how reperfusion delays affect outcomes in patients with versus without cardiogenic shock.

Does increased first medical contact-to-device time increase in-hospital mortality and major adverse cardiovascular events in STEMI patients with and without cardiogenic shock?

Population

STEMI patients undergoing primary percutaneous coronary angiography stratified by cardiogenic shock

Comparison

FMC-to-percutaneous coronary angiography time in cardiogenic shock vs non-shock groups

Design

Retrospective registry analysis

Follow-up

In-hospital

Authors

AKAndrew KochanTLTerry LeeNMNima Moghaddam

Discussion

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Overview

Mortality rises steeply with delays in shock; extends observational data on FMC-to-device time but leaves causality open.

Structured PICO

Does increased first medical contact-to-device time increase in-hospital mortality and major adverse cardiovascular events in STEMI patients with and without cardiogenic shock?

P
Population
Patients with ST-segment-elevation myocardial infarction (STEMI) who received primary percutaneous coronary angiography between January 1, 2010, and December 31, 2020, stratified by presence or absence of cardiogenic shock at hospital arrival.
I
Intervention
Increased first medical contact (FMC)-to-device time (reperfusion delay)
C
Comparator
Shorter FMC-to-device times and comparison between patients with vs. without cardiogenic shock
O
Outcome
In-hospital mortalityhard clinical

Reperfusion delays are associated with a significantly steeper increase in absolute mortality for STEMI patients presenting with cardiogenic shock compared to those without shock.

Cite This Study

Kochan et al. (2023) studied this question.

synapsesocial.com/papers/6a0f4323e51a776886ed0d0ahttps://doi.org/10.1161/circinterventions.122.012810
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