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This study analyzed 1605 myocardial infarction patients over 24 years, finding cardiogenic shock significantly increased mortality despite decreasing incidence. Early identification and management of risk factors are crucial for improving outcomes in myocardial infarction patients experiencing cardiogenic shock.
Area of Science:
- Cardiology
- Internal Medicine
- Public Health
Background:
- Myocardial infarction (MI) remains a leading cause of mortality worldwide.
- Cardiogenic shock (CS) is a severe complication of MI with high fatality rates.
- Understanding trends in MI and CS incidence and outcomes is vital for public health strategies.
Purpose of the Study:
- To analyze the incidence, clinical characteristics, and outcomes of patients with myocardial infarction.
- To specifically investigate the trends and lethality of cardiogenic shock in myocardial infarction patients.
- To identify associated risk factors and clinical presentations of cardiogenic shock in MI.
Main Methods:
- Retrospective analysis of 1605 patients admitted with myocardial infarction over a 24-year period.
- Data collection included patient demographics, clinical presentation, MI localization, and comorbidities.
- Analysis of incidence, mortality, and risk factors for cardiogenic shock in MI patients.
Main Results:
- Overall MI mortality was 26.5%. Cardiogenic shock occurred in 10.3% of MI patients, with a high lethality of 85%.
- Over 5 years, CS incidence decreased from 14.4% to 5.3%, but lethality increased from 75.5% to 91.4%.
- Common presentations included angina pectoris (80%), asthmatic (49%) and irradiating pain (41%). Hypertension (21.7%), diabetes (15%), and rhythm disorders (32.2%) were notable comorbidities.
Conclusions:
- Despite a decrease in incidence, cardiogenic shock in myocardial infarction presents a growing challenge due to increased lethality.
- The study highlights the critical need for improved management strategies for cardiogenic shock in MI patients.
- Further research into risk stratification and early intervention for high-risk MI patients is warranted.
Abstract:
A total of 1605 patients with myocardial infarction had been admitted to the district hospital--Sliven for 24 years. The percentage of the deceased out of them is 26.5%. The patients with cardiogenic shock were 166 (10.3%) and 131 of them died (85%). The cardiogenic shock in myocardial infarction reduced its incidence within the 5 years, from 14/4% to 5.3%, and lethality was increased from 75.5 to 91.4%. The males represented 60%. To the age of 60 proved to be 30.1% of the patients. To the age of 45-3.6%; to from 46 to 60-26.5%; from 61 to 75-51.6% and over the age of 75-18%. Angina pectoris was present in 80% in the clinic of the patients with cardiogenic shock in myocardial infarction, with irradiating pain--41%, with asthmatic manifestations--49%, with abdominal manifestations--20% and cerebral manifestations--23%. According to localization the myocardial infarction was grouped as follows: 8.4%--anteroseptal; 17.4%--anterior, 9.6%--massive anterior, 1.8--anterior-apical, 6.4%--anterior lateral, 25.3%--posterior, 9%--posterior-lateral, 5.6%--anterior-posterior, 0.6%--focal and 1% subendocardial. Hypertension proved to be a favourable factor in the development of cardiogenic shock in myocardial infarction in 21.7% as well as diabetes in 15%, rhythm disorders--in 32.2%, pulmonary embolism in 7.9% and decompensation in 14.4%.