Temporal Trends in Cardiogenic Shock Complicating Acute Myocardial Infarction in South Korea

We aimed to study temporal trends in cardiogenic shock (CS) complicating acute myocardial infarction (AMI) and assessed the predictors of shock development during hospitalization and of mortality.

Data were obtained from 2 Korean AMI Registries (KAMIRs), the KAMIR-National Institutes of Health (early) and KAMIR-V (late). Patients with CS were those with CS before admission (ba-CS) and those who developed CS during admission as a complication of AMI (da-CS). Temporal trends were examined as early (2011-2015) and late (2016-2020) periods.

A total of 28,990 patients was included, of whom 3,179 (11.0%) had CS. The overall prevalence of CS decreased from 12.5% to 9.6% (p for trend <0.001). Among CS patients, 1,900 (59.8% of those with CS) had ba-CS and 1,279 developed da-CS. The prevalence of both ba- (7.1% to 6.1%, p<0.001) and da-CS (5.4% to 3.6%, p<0.001) decreased, while the use of percutaneous coronary intervention increased. Over the 10-year period, in-hospital mortality rates decreased in overall CS (from 27.3% to 22.9%; p=0.004) and ba-CS (from 25.1% to 17.0%; p<0.001), but not in da-CS (from 30.3% to 32.9%; p=0.335).

The decline in mortality rates of overall and ba-CS but not that of da-CS emphasizes the need for enhanced prevention strategies, early identification of development of CS after admission, and alternative therapeutic strategies for patients at high risk of CS in the acute stage of AMI.