Prognosis of patients with cardiogenic shock following acute myocardial infarction: The difference between ST-segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction

Abstract

Acute myocardial infarction (AMI) complicated by cardiogenic shock has high mortality and remains challenging even in the revascularization era. We conducted this study to understand patients' outcomes. We retrospectively analyzed electronic medical records data from 1175 patients with AMI complicated by cardiogenic shock that developed within 3 days of admission to a multicenter medical care system between January 1, 2000, and July 31, 2018. Patients with AMI were classified into the ST-segment elevation MI (STEMI) group or the non-ST-segment elevation MI (NSTEMI) group. The short-term and 1-year mortality and adverse events after index admission were analyzed via logistic regression and a Cox proportional hazards model. When compared with NSTEMI, patients with STEMI tended to be younger (65.68 ± 14.05 years vs 70.70 ± 12.99 years, P < .001), men (73.29% vs 60.87%, P < .001), and have fewer underlying chronic diseases. Short-term mortality at index hospitalization was 14.83% in the STEMI group and 21.30% in the NSTEMI group; long-term mortality was 17.06% for the STEMI group and 24.13% for the NSTEMI group. No difference was observed between the 2 groups for patients who developed a cerebral vascular accident during the admission period. However, the major and gastrointestinal bleeding rates were higher in the STEMI group (2.66% vs 0.22%, P = .014; 3.36% vs 0.22%, P = .007, respectively). Age and respiratory failure were the most significant risk factors for short-term mortality. Revascularization may be beneficial for the short-term outcome but did not reach significance in multivariable analysis. In patients with AMI with cardiogenic shock, NSTEMI was associated with a significantly higher mortality rate in short-term results.

Effect of sex on the association between arterial partial pressure of oxygen and in-hospital mortality in ICU patients with cardiogenic shock: a retrospective cohort study

“…Based on the published literature and clinical experience, we included the following variables in this study: demographic information (age, sex) ( 14 ), vital signs and laboratory tests ( 15 ) [heart rate, mean arterial pressure (MAP), respiratory rate, glucose, hemoglobin, platelet, white blood cell (WBC) count, bicarbonate, creatinine, sodium, potassium], the vasopressors used on the first day of ICU admission, disease comorbidities ( 16 ) (chronic pulmonary disease, hypertension, myocardial infarction, congestive heart failure, rheumatic disease, peptic ulcer disease, renal disease, and diabetes), and disease severity scores [the Oxford acute severity of illness score (OASIS)] ( 17 ), simplified acute physiology score (SOFA) ( 18 ), and simplified acute physiology score (SAPS) II ( 19 ). Illness severity (OASIS, SOFA and SAPS II scores) were calculated on the worst values in the first 24 hours in the ICU.…”