What question did this study set out to answer?

This research aims to assess the historical changes in incidence and outcomes of cardiogenic shock in patients with acute myocardial infarction between 1995 and 2005.

August 26, 2012European Heart JournalOpen Access

Improved outcome of cardiogenic shock at the acute stage of myocardial infarction: a report from the USIK 1995, USIC 2000, and FAST-MI French Nationwide Registries

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Why the study?

Does modern management including increased PCI use reduce early mortality in AMI patients with cardiogenic shock compared to historical management?

Population

7,531 consecutive acute myocardial infarction patients presenting ≤48 h of symptom onset, including 486 with…

Comparison

Management in 2005 vs Historical management in 1995

Design

Cohort

Follow-up

1 year

Authors

NANadia AïssaouiUniversité Paris Cité EPE. PuymiratHôpital Européen XTX TaboneConservatoire National des Arts et Métiers

Discussion

Member takes

Implication

Observed CS mortality decline with PCI use is hypothesis-generating; leaves open causal confirmation by randomized trials.

Key Points

This research aims to assess the historical changes in incidence and outcomes of cardiogenic shock in patients with acute myocardial infarction between 1995 and 2005.
Analyzed data from three French nationwide registries conducted five years apart.
Included 7531 AMI patients presenting within 48 hours of symptom onset.
Compared mortality and PCI use between patients with and without cardiogenic shock over the time period.
Thirty-day mortality was significantly higher in CS patients (60.9%) compared to those without (5.2%).
Mortality decreased in both CS (from 70% to 51%) and non-CS (from 9% to 4%) over the decade with p-values < 0.001.
In CS patients, the use of PCI increased significantly from 20% to 50%, associated with decreased mortality (OR 0.38, 95% CI: 0.24-0.58, P < 0.001).

Structured PICO

Does modern management including increased PCI use reduce early mortality in AMI patients with cardiogenic shock compared to historical management?

Population

7,531 consecutive acute myocardial infarction (AMI) patients presenting ≤48 h of symptom onset, including 486 with cardiogenic shock (CS), from three French nationwide registries (1995, 2000, 2005).

Intervention

Management in 2005 (including 50% PCI use and recommended medications)

Comparator

Historical management in 1995 (including 20% PCI use)

Outcome

30-day mortalityhard clinical

Early mortality in AMI complicated by cardiogenic shock significantly decreased over a 10-year period, driven by increased use of PCI and recommended medications, though 1-year survival remained unchanged.

Cite This Study

Aïssaoui et al. (2012) studied this question.

synapsesocial.com/papers/6a0faef64fb650da4ffe642d https://doi.org/10.1093/eurheartj/ehs264

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Improved outcome of cardiogenic shock at the acute stage of myocardial infarction: a report from the USIK 1995, USIC 2000, and FAST-MI French Nationwide Registries

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Improved outcome of cardiogenic shock at the acute stage of myocardial infarction: a report from the USIK 1995, USIC 2000, and FAST-MI French Nationwide Registries

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Also Consider