Cardiogenic shock (CS) is a catastrophic consequence of ST-elevation myocardial infarction
(STEMI). CS has been reported to be associated less often with inferior wall (IWMI)
than anterior wall STEMI (AWMI). We queried the National Inpatient Sample databases
from January 2010 to September 2015 to identify all patients aged ≥18 years admitted
with AWMI or IWMI. Patients with a concomitant diagnosis of CS were then identified.
Complex samples multivariable logistic regression models were used to compare the
incidence, management, and in-hospital mortality of CS complicating IWMI versus AWMI.
The incidence of CS was lower in IWMI (9.5%) versus AWMI (14.1%), adjusted OR (aOR)
0.84 (95% confidence interval [CI] 0.81 to 0.87). Revascularization rates with either
percutaneous coronary intervention or coronary artery bypass grafting were similar
in CS complicating IWMI versus AWMI (80.9% vs 80.3%; aOR 1.05; 95% CI 0.97 to 1.14).
The reported use of percutaneous mechanical circulatory support devices was lower
in patients with CS-IWMI versus CS-AWMI (44.7% vs 61.0%; aOR 0.55; 95% CI 0.52 to
0.59). In-hospital mortality was modestly lower in patients with CS complicating IWMI
versus AWMI (30.3% vs 31.9%; aOR, 0.80; 95% CI 0.75 to 0.86). Use of percutaneous
mechanical circulatory support was not associated with lower in-hospital mortality
in either CS-AWMI (30.0% vs 34.7; aOR 1.04; 95% CI 0.94 to 1.14) or CS-IWMI (31.0%
vs 29.8%; aOR 1.20; 95% CI 1.08 to 1.33). In conclusion, the incidence of CS in the
contemporary era is lower in patients with IWMI compared with those with AWMI. CS
complicating STEMI is associated with higher in-hospital mortality in AWMI versus
IWMI, and outcomes were not different with or without percutaneous circulatory support.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to American Journal of CardiologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Temporal trends in cardiogenic shock complicating acute myocardial infarction.N Engl J Med. 1999; 340: 1162-1168
- A prospective survey of the characteristics, treatments and outcomes of patients with acute coronary syndromes in Europe and the Mediterranean basin; the Euro Heart Survey of Acute Coronary Syndromes (Euro Heart Survey ACS).Eur Heart J. 2002; 23: 1190-1201
- Improved outcome of cardiogenic shock at the acute stage of myocardial infarction: a report from the USIK 1995, USIC 2000, and FAST-MI French nationwide registries.Eur Heart J. 2012; 33: 2535-2543
- Ten-year trends in the incidence and treatment of cardiogenic shock.Ann Intern Med. 2008; 149: 618-626
- Trends in incidence, management, and outcomes of cardiogenic shock complicating ST-elevation myocardial infarction in the United States.J Am Heart Assoc. 2014; 3e000590
- Thirty-year trends (1975 to 2005) in the magnitude of, management of, and hospital death rates associated with cardiogenic shock in patients with acute myocardial infarction: a population-based perspective.Circulatio. 2009; 119: 1211-1219
- Trends in management and outcomes of patients with acute myocardial infarction complicated by cardiogenic shock.JAMA. 2005; 294: 448-454
- 17-year trends in incidence and prognosis of cardiogenic shock in patients with acute myocardial infarction in western Sweden.Int J Cardiol. 2015; 185: 256-262
- Temporal trends and outcomes of patients undergoing percutaneous coronary interventions for cardiogenic shock in the setting of acute myocardial infarction: a report from the CathPCI Registry.JACC Cardiovasc Interv. 2016; 9: 341-351
- Coronary artery disease in patients dying from cardiogenic shock or congestive heart failure in the setting of acute myocardial infarction.Br Heart J. 1976; 38: 906-910
- Cardiogenic shock.Cardiol Clin. 2013; 31: 567-580
- Cardiogenic shock complicating acute myocardial infarction–etiologies, management and outcome: a report from the SHOCK Trial Registry. Should we emergently revascularize Occluded Coronaries for cardiogenic shocK?.J Am Coll Cardiol. 2000; 36: 1063-1070
- Meta-analysis evaluating the effect of left coronary dominance on outcomes after percutaneous coronary intervention.Am J Cardiol. 2018; 122: 2026-2034
Overview of the National (Nationwide) Inpatient Sample (NIS). Available at: http://www.hcup-us.ahrq.gov/nisoverview.jsp. Accessed April 21, 2019.
Checklist for Working with the NIS. Available at: https://www.hcup-us.ahrq.gov/db/nation/nis/nischecklist.jsp. Accessed April 21, 2019.
- Outcomes and temporal trends of inpatient percutaneous coronary intervention at centers with and without on-site Cardiac Surgery in the United States.JAMA Cardiol. 2017; 2: 25-33
- Management and outcomes of ST-segment elevation myocardial infarction in US renal transplant recipients.JAMA Cardiol. 2017; 2: 250-258
- Contemporary management of cardiogenic shock: a scientific statement from the American Heart Association.Circulation. 2017; 136: e232-e268
- 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines.J Am Coll Cardiol. 2013; 61: e78-e140
- Early revascularization in acute myocardial infarction complicated by cardiogenic shock. SHOCK Investigators. Should We Emergently Revascularize Occluded Coronaries for Cardiogenic Shock.N Engl J Med. 1999; 341: 625-634
- Cardiogenic shock caused by right ventricular infarction: a report from the SHOCK registry.J Am Coll Cardiol. 2003; 41: 1273-1279
- Comparison of late survival in patients with cardiogenic shock due to right ventricular infarction versus left ventricular pump failure following primary percutaneous coronary intervention for ST-elevation acute myocardial infarction.Am J Cardiol. 2007; 99: 431-435
- Intraaortic balloon support for myocardial infarction with cardiogenic shock.N Engl J Med. 2012; 367: 1287-1296
- Shock in acute myocardial infarction: the Cape Horn for trials?.Eur Heart J. 2010; 31: 1828-1835
- Percutaneous left ventricular assist devices vs. intra-aortic balloon pump counterpulsation for treatment of cardiogenic shock: a meta-analysis of controlled trials.Eur Heart J. 2009; 30: 2102-2108
- Percutaneous left ventricular assist devices in acute myocardial infarction complicated by cardiogenic shock.Eur Heart J. 2007; 28: 2057-2063
- A randomized clinical trial to evaluate the safety and efficacy of a percutaneous left ventricular assist device versus intra-aortic balloon pumping for treatment of cardiogenic shock caused by myocardial infarction.J Am Coll Cardiol. 2008; 52: 1584-1588
- Percutaneous mechanical circulatory support versus intra-aortic balloon pump in cardiogenic shock after acute myocardial infarction.J Am Coll Cardiol. 2017; 69: 278-287
- A diagnostic accuracy study validating cardiovascular ICD-9-CM codes in healthcare administrative databases. The Umbria Data-Value Project.PLoS One. 2019; 14e0218919
Article info
Publication history
Published online: January 07, 2020
Received in revised form:
December 18,
2019
Received:
September 24,
2019
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
