Cardiogenic Shock With Acute Myocardial Infarction Among Older Adults in the United States

Characteristics and outcomes associated with cardiogenic shock (CS) with acute myocardial infarction (AMI) in older patients have not been well characterized.

The purpose of this study was to investigate characteristics and outcomes of older patients admitted with CS with AMI.

We used the National Inpatient Sample database to evaluate clinical characteristics of hospitalizations, clinical outcomes, and health care utilization of hospitalizations of older patients ≥80 years with CS and AMI from 2003 to 2021. We also compared data from older patients with a reference relatively younger patient population (18-79 years).

During the study period, 207,333 hospitalizations of older patients ≥80 years and 675,491 hospitalizations of patients 18 to 79 years were identified. Between the first 4 years of the study period (2003-2006) and the final 4-year interval of the study period (2016-2019), there was an increase in the number of hospitalizations of older patients with AMI and CS (39,220-51,640). On adjusted analysis, there were increases in the percentage of older patients undergoing treatment with percutaneous coronary intervention (19.2% to 34.1%; P < 0.001) and encounters for palliative care (2.0% to 32.4%; P < 0.001) alongside a decline in in-hospital mortality (61.4% to 49.0%; P < 0.001) over the study period. Compared to patients 18 to 79 years of age, those aged ≥80 years had greater in-hospital mortality (51.8% vs 33.0%; P < 0.001).

From 2003 to 2021, for older patients with CS and AMI, hospitalizations increased, and mortality decreased.