Long-Term Outcomes of Cardiogenic Shock Complicating Myocardial Infarction
Recommended Citation
Sterling LH, Fernando SM, Talarico R, Qureshi D, van Diepen S, Herridge MS, Price S, Brodie D, Fan E, Di Santo P, Jung RG, Parlow S, Basir MB, Scales DC, Combes A, Mathew R, Thiele H, Tanuseputro P, and Hibbert B. Long-Term Outcomes of Cardiogenic Shock Complicating Myocardial Infarction. J Am Coll Cardiol 2023; 82(10):985-995.
Document Type
Article
Publication Date
9-5-2023
Publication Title
Journal of the American College of Cardiology
Keywords
Adult, Humans, Male, Middle Aged, Aged, Aged, 80 and over, Female, Shock, Cardiogenic, Aftercare, Retrospective Studies, Patient Discharge, Myocardial Infarction, Ontario
Abstract
BACKGROUND: Cardiogenic shock secondary to acute myocardial infarction (AMI-CS) is associated with substantial short-term mortality; however, there are limited data on long-term outcomes and trends.
OBJECTIVES: This study sought to examine long-term outcomes of AMI-CS patients.
METHODS: This was a population-based, retrospective cohort study in Ontario, Canada of critically ill adult patients with AMI-CS who were admitted to hospitals between April 1, 2009 and March 31, 2019. Outcome data were captured using linked health administrative databases.
RESULTS: A total of 9,789 consecutive patients with AMI-CS from 135 centers were included. The mean age was 70.5 ± 12.3 years, and 67.7% were male. The incidence of AMI-CS was 8.2 per 100,000 person-years, and it increased over the study period. Critical care interventions were common, with 5,422 (55.4%) undergoing invasive mechanical ventilation, 1,425 (14.6%) undergoing renal replacement therapy, and 1,484 (15.2%) receiving mechanical circulatory support. A total of 2,961 patients (30.2%) died in the hospital, and 4,004 (40.9%) died by 1 year. Mortality at 5 years was 58.9%. Small improvements in short- and long-term mortality were seen over the study period. Among survivors to discharge, 2,870 (42.0%) required increased support in care from their preadmission baseline, 3,244 (47.5%) were readmitted to the hospital within 1 year, and 1,047 (15.3%) died within 1 year. The mean number of days at home in the year following discharge was 307.9 ± 109.6.
CONCLUSIONS: Short- and long-term mortality among patients with AMI-CS is high, with minimal improvement over time. AMI-CS survivors experience significant morbidity, with high risks of readmission and death. Future studies should evaluate interventions to minimize postdischarge morbidity and mortality among AMI-CS survivors.
Medical Subject Headings
Adult; Humans; Male; Middle Aged; Aged; Aged, 80 and over; Female; Shock, Cardiogenic; Aftercare; Retrospective Studies; Patient Discharge; Myocardial Infarction; Ontario
PubMed ID
37648357
Volume
82
Issue
10
First Page
985
Last Page
995
