Key result
STEMI with cardiogenic shock shows similar in-hospital mortality compared to NSTEMI.
Why the study?
Evidence exploring differences in characteristics and outcomes between patients with STEMI and NSTEMI presenting with cardiogenic shock was limited.
Does STEMI compared to NSTEMI affect in-hospital mortality and clinical outcomes in adults presenting with cardiogenic shock?
Meta-Analysis (n=174,129)
Does STEMI compared to NSTEMI affect in-hospital mortality and clinical outcomes in adults presenting with cardiogenic shock?
Odds Ratio: 0.82 (95% CI 0.52–1.3)
In patients with cardiogenic shock, in-hospital mortality is similar between STEMI and NSTEMI presentations, although STEMI patients are generally younger and have fewer baseline comorbidities.
In-hospital mortality risk is similar for STEMI-CS and NSTEMI-CS; confirms equivalent prognosis and supports unified shock management protocols.
BACKGROUND: There is limited evidence exploring the differences in characteristics and outcomes between patients with ST-segment elevation myocardial infarction (STEMI) and with non-ST-segment elevation myocardial infarction (NSTEMI) presenting with cardiogenic shock (CS). METHODS: Medline, Google Scholar, and ScienceDirect databases were searched up to March 2025. Studies reporting data on STEMI-CS and NSTEMI-CS patient characteristics and clinical outcomes were included. Pooled risk ratios (odds ratios [ORs]) and standardized mean differences (SMDs) were calculated using random-effects models, and the I2 statistic measured heterogeneity. The risk of bias was assessed using the Newcastle-Ottawa Scale. RESULTS: The pooled analysis of 12 studies demonstrated that the incidence of in-hospital mortality was comparable between STEMI-CS and NSTEMI-CS patients (pooled OR: 0.82, 95% confidence interval [CI]: 0.52-1.30, I2 = 98.7%, P < .001). However, STEMI-CS patients had a considerably lower age of presentation (pooled SMD: -0.54, 95% CI: -0.67 to -0.42, I2 = 96.9%, P < .001), as well as lower incidence of prior heart failure, prior myocardial infarction, and diabetes, compared to NSTEMI-CS patients (P < .05). Conversely, STEMI-CS was associated with shorter hospital stays (pooled SMD: -0.54, 95% CI: -0.77 to -0.31, I2 = 99.1%, P < .001). CONCLUSION: While the incidence of in-hospital mortality did not significantly differ between STEMI-CS and NSTEMI-CS patients, the study further emphasizes the importance of individualized treatment strategies based on myocardial infarction type and patient characteristics when managing CS patients.
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Z. Sheng (2025) conducted a meta-analysis in Cardiogenic shock complicating acute myocardial infarction (n=174,129). ST-segment elevation myocardial infarction (STEMI) vs. Non-ST-segment elevation myocardial infarction (NSTEMI) was evaluated on In-hospital mortality (OR 0.82, 95% CI 0.52-1.30). ST-segment elevation myocardial infarction with cardiogenic shock was associated with a similar incidence of in-hospital mortality compared to non-ST-segment elevation myocardial infarction (OR 0.82).
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