Treatment Intensity for the Management of Cardiogenic Shock

作者：Shashank S. Sinha, Mohit Pahuja, Rachna Kataria, Vanessa Blumer, Jaime Hernández-Montfort, Manreet Kanwar, A.R. Garan, Yijing Zhang, Jeffrey A. Marbach, Adnan Khalif, Saraschandra Vallabhajosyula, Sandeep Nathan, Jacob Abraham, Borui Li, Katherine Thayer, Paulina Baca, Fatou Dieng, Neil Harwani, Michael Yaoyao Yin, Anthony J. Faugno, Haroon Faraz, Maya Guglin, Gavin Hickey, Detlef Wencker, Shelley Hall, Andrew Schwartzman, Wissam Khalife, Song Li, Claudius Mahr, Ju H. Kim, Arvind Bhimaraj, Van‐Khue Ton, Esther Vorovich, Daniel Burkhoff, Navin K. Kapur · 发表于：JACC Advances · 年份：2023 · DOI：10.1016/j.jacadv.2023.100314 · 被引用次数：18 · 研究领域：Mechanical Circulatory Support Devices、Acute Myocardial Infarction Research、Cardiac Structural Anomalies and Repair

Cardiogenic shock is a leading cause of mortality in patients with acute myocardial infarction. The authors sought to compare clinical characteristics, hospital trajectory, and drug and device use between patients with ST-segment elevation myocardial infarction-related cardiogenic shock (STEMI-CS) and those without (non-ST-segment elevation myocardial infarction complicated by cardiogenic shock [NSTEMI-CS]). We analyzed data from 1,110 adult admissions with cardiogenic shock complicating acute myocardial infarction (AMI-CS) across 17 centers within Cardiogenic Shock Working Group. The primary end point was in-hospital mortality. Our study included 1,110 patients with AMI-CS, of which 731 (65.8%) had STEMI-CS and 379 (34.2%) had NSTEMI-CS. Most patients were male (STEMI-CS: 71.6%, NSTEMI-CS: 66.5%) and White (STEMI-CS: 53.8%, NSTEMI-CS: 64.1%). In-hospital mortality was 41% and was similar among patients with STEMI-CS and NSTEMI-CS (43% vs 39%, P = 0.23). Patients with out-of-hospital cardiac arrest had higher in-hospital mortality in patients with NSTEMI-CS (63% vs 36%, P = 0.006) as compared to patients with STEMI-CS (52% vs 41%, P = 0.16). Similar results were observed for in-hospital cardiac arrest in patients with STEMI-CS (63% vs 33%, P < 0.001) and NSTEMI-CS (60% vs 32%, P < 0.001). Only 27% of patients with STEMI-CS and 12% of NSTEMI-CS received both a drug and temporary mechanical circulatory support device during the first 24 hours, which increased to 78% and 61%, re...