Key result
The prognostic impact of diabetes mellitus in MI-CS was lower at older ages, and ICCU availability and revascularization were associated with better outcomes.
Why the study?
The prognostic role of DM in elderly patients with MI-CS remains controversial, and little is known about the impact of ICCU management and revascularization on their outcomes.
Does ICCU management and revascularization improve in-hospital mortality in elderly patients with myocardial infarction-related cardiogenic shock, and how does diabetes mellitus impact prognosis?
Observational
Yes
Does ICCU management and revascularization improve in-hospital mortality in elderly patients with myocardial infarction-related cardiogenic shock, and how does diabetes mellitus impact prognosis?
In elderly patients with MI-related cardiogenic shock, the prognostic impact of diabetes is attenuated, while ICCU availability and revascularization remain associated with improved survival.
Answers are grounded in this paper and cite their sources.
ICCU and revascularization were associated with better MI-CS outcomes across ages; leaves causal effects and diabetes attenuation open in elderly patients.
BACKGROUND: The prognostic role of diabetes mellitus (DM) in elderly patients with myocardial infarction-related cardiogenic shock (MI-CS) remains controversial. Little information exists about the impact of intensive cardiac care unit (ICCU) and revascularization on outcomes of elderly patients with MI-CS. We aimed to assess the prognostic impact of DM according to age in patients with MI-CS, and to analyze the impact ICCU management and revascularization on in-hospital mortality in MI-CS patients at older ages. METHODS: Discharge episodes with diagnosis of CS associated with MI were selected from the Spanish National Health System's Basic Data Set. Centers were classified according to their availability of ICCU. Main outcome measured was in-hospital mortality. CONCLUSIONS: Prognostic impact of DM in patients with MI-CS was different according to age, with a significantly lower impact at older ages. The availability of ICCU and revascularization were associated with better outcomes in these complex patients.
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Gual et al. (2020) conducted an observational in Myocardial infarction-related cardiogenic shock. Diabetes mellitus, ICCU management, and revascularization vs. No diabetes, no ICCU, no revascularization was evaluated on In-hospital mortality (p=<0.001). The prognostic impact of diabetes mellitus in MI-CS was lower at older ages, and ICCU availability and revascularization were associated with better outcomes.
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