Related Experiment Video
Updated: May 10, 2026
Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
Published on: June 12, 2021
[Acute myocardial infarction complicated by cardiogenic shock: what changed over a 10-year time span?]
Hélder Dores1, Jorge Ferreira, Francisco Costa
1Serviço de Cardiologia, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Portugal.
Insights
Despite advances in treatment for cardiogenic shock (CS) after heart attack, mortality rates remain high. This study found no significant change in short- and medium-term survival over a decade, even with earlier admissions and increased interventions.
Area of Science:
- Cardiology
- Intensive Care Medicine
- Clinical Research
Background:
- Mortality associated with cardiogenic shock (CS) following acute myocardial infarction (AMI) remains a significant clinical challenge.
- Despite therapeutic advancements, high mortality rates persist in patients experiencing CS post-AMI.
Purpose of the Study:
- To compare clinical characteristics, management strategies, and outcomes of patients admitted with CS over two distinct 10-year periods.
- To identify independent predictors of six-month mortality in patients with CS.
Main Methods:
- Retrospective analysis of two patient cohorts with CS admitted between May 1998-May 2001 (Group A) and May 2008-May 2011 (Group B).
- Comparison of clinical data, diagnostic approaches, treatments, and patient outcomes.
- Statistical analysis to determine independent predictors of six-month mortality.
Main Results:
- The incidence of CS slightly increased from 3.7% to 4.8% over the decade.
- Patients in the later cohort were older and more likely to be admitted within six hours of symptom onset.
- While pulmonary artery catheterization use decreased, dialysis and percutaneous coronary intervention (PCI) use increased.
- No significant differences were observed in 30-day or six-month mortality rates between the two groups.
- Diabetes mellitus was identified as an independent predictor of six-month mortality.
Conclusions:
- Despite earlier hospital admission and increased utilization of support therapies and PCI, short- and medium-term mortality for cardiogenic shock following acute myocardial infarction has not significantly changed over a 10-year period.
- Revascularization strategies were associated with improved survival in patients with CS.
Background:
Despite improvements in treatment, mortality associated with cardiogenic shock (CS) following acute myocardial infarction remains high.
Aim:
To compare two groups of patients admitted with CS over a 10-year time span.
Methods:
We performed a retrospective analysis of two patient populations presenting with CS admitted in the periods May 1998-May 2001 (group A) and May 2008-May 2011 (group B). Clinical characteristics, diagnostic methods, treatment and outcomes were compared, and independent predictors of death at six months were analyzed.
Results:
The incidence of CS was 3.7% in group A (n=25) and 4.8% in group B (n=42). There were no significant differences in clinical characteristics except for age (60.2±12.3 vs. 66.5±11.3 years; p=0.043) and the proportion of patients admitted within six hours of symptom onset (29.2% vs. 54.8%, p=0.045). There was a reduction in use of pulmonary artery catheterization (52.0% vs. 19.0%, p=0.005) but an increase in dialysis (4.0% vs. 28.6%, p=0.014). There was no difference in the proportion of patients reperfused within 12 hours or revascularized, but use of percutaneous coronary intervention (PCI) increased (75.0% vs. 92.9%, p=0.042). There were no differences in outcomes, including mortality at 30 days (32.0 vs. 35.7%; p=0.757) and six months (36.0 vs. 42.9%; p=0.683). Diabetes was the sole baseline characteristic identified as an independent predictor of death at six months (hazard ratio [HR] 3.02; 95% confidence interval [CI] 1.38-6.60; p=0.006) and mortality was lower among revascularized patients (HR 0.11; 95% CI 0.03-0.42; p=0.001).
Conclusions:
Over a 10-year time span, despite earlier hospital admission and increased use of support therapies and PCI, short- and medium-term mortality remained unchanged.
Related Concept Videos
01:28Acute Coronary Syndrome IV: Interprofessional Care
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
01:30Acute Coronary Syndrome I: Introduction
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:25Cardiopulmonary Resuscitation IV: Pharmacological Management
01:30Introduction Cardiac Emergencies