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Related Experiment Video

Updated: May 28, 2026

Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
06:10

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Published on: June 12, 2021

Intubation Rather Than Cardiac Arrest as a Risk-Modifier of Mortality in Infarction-Related Cardiogenic Shock.

S Ten Berg1, M Bogerd1, M J C Timmermans2

  • 1Department of Cardiology, Amsterdam UMC, Amsterdam, The Netherlands.

Journal of Cardiac Failure
|May 26, 2026
PubMed
Summary

Out-of-hospital cardiac arrest (OHCA) characteristics impact mortality risk in acute myocardial infarction-cardiogenic shock (AMICS) patients. Intubation independently predicted higher 30-day mortality across all AMICS subgroups.

Keywords:
Myocardial infarctioncardiac arrestcardiogenicintubationshock

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Published on: August 16, 2021

Area of Science:

  • Cardiology
  • Critical Care Medicine
  • Interventional Cardiology

Background:

  • The Society for Cardiovascular Angiography and Intervention (SCAI) proposed an arrest modifier for cardiogenic shock (CS) stages.
  • Outcomes vary significantly based on favorable versus unfavorable out-of-hospital cardiac arrest (OHCA) characteristics.
  • Intubation may reflect critical illness severity and predict mortality in acute myocardial infarction-cardiogenic shock (AMICS) patients.

Purpose of the Study:

  • To determine if "arrest" is a justified modifier in the SCAI classification by comparing 30-day mortality in AMICS patients with and without OHCA.
  • To evaluate the impact of intubation on 30-day mortality across different AMICS patient categories.

Main Methods:

  • Utilized data from the Netherlands Heart Registration (2017-2021) involving 14 hospitals.
  • Stratified 2226 AMICS patients undergoing percutaneous coronary intervention (PCI) into three groups: AMICS without OHCA, favorable AMICS-OHCA, and unfavorable AMICS-OHCA.
  • Employed multivariable Cox regression to compare 30-day mortality and conducted subgroup analyses on intubation's association with mortality.

Main Results:

  • Favorable AMICS-OHCA was linked to lower 30-day mortality (HR 0.74), while unfavorable AMICS-OHCA showed higher risk (HR 1.31) compared to AMICS without OHCA.
  • Intubation was consistently associated with increased 30-day mortality across all patient subgroups.
  • The study included 1313 patients without OHCA, 490 with favorable OHCA, and 423 with unfavorable OHCA.

Conclusions:

  • 30-day mortality risk in AMICS patients undergoing PCI differs significantly between favorable and unfavorable OHCA.
  • Intubation emerged as an independent predictor of 30-day mortality in all studied AMICS subgroups.
  • Findings suggest a need for more detailed OHCA characterization beyond a simple binary modifier and support investigating intubation's role in the SCAI shock classification.