3ead7e8e26e392cc79117eec0c84c6d5 jouclimed_a2020v9n8p2398.pdf 189adb79196e1ae4808ab8df98106569a04516e6 jouclimed_a2020v9n8p2398.pdf 35032a792a9ee9e744a64558284272cad4f5ff1a2ffc4373e27cbefb3b542273 jouclimed_a2020v9n8p2398.pdf Title: Short- and Long-Term Mortality Trends in STEMI-Cardiogenic Shock over Three Decades (1989–2018): The Ruti-STEMI-Shock Registry Subject: Aims: Cardiogenic shock (CS) is an ominous complication of ST-elevation myocardial infarction (STEMI), despite the recent widespread use of reperfusion and invasive management. The Ruti-STEMI-Shock registry analysed the prevalence of and 30-day and 1-year mortality rates in ST-elevation myocardial infarction (STEMI) complicated by CS (STEMI-CS) over the last three decades. Methods and Results: From February 1989 to December 2018, 493 STEMI-CS patients were consecutively admitted in a well-defined geographical area of ~850,000 inhabitants. Patients were classified into six five-year periods based on their year of admission. STEMI-CS mortality trends were analysed at 30 days and 1 year across the six strata. Cox regression analyses were performed for comparisons. Mean age was 67.5 11.7 years; 69.4% were men. STEMI-CS prevalence did not decline from period 1 to 6 (7.1 vs. 6.2%, p = 0.218). Reperfusion therapy increased from 22.5% in 1989–1993 to 85.4% in 2014–2018. Thirty-day all-cause mortality declined from period 1 to 6 (65% vs. 50.5%, p < 0.001), with a 9% reduction after multivariable adjustment (HR: 0.91; 95% CI: 0.84–0.99; p = 0.024). One-year all-cause mortality declined from period 1 to 6 (67.5% vs. 57.3%, p = 0.001), with an 8% reduction after multivariable adjustment (HR: 0.92; 95% CI: 0.85–0.99; p = 0.030). Short- and long-term mortality trends in patients aged 75 years remained ~75%. Conclusions: Short- and long-term STEMI-CS-related mortality declined over the last 30 years, to ~50% of all patients. We have failed to achieve any mortality benefit in STEMI-CS patients over 75 years of age. Keywords: ST-elevation myocardial infarction; prognosis; STEMI complications; STEMI mortality Author: Cosme García-García, Teresa Oliveras, Nabil El Ouaddi, Ferran Rueda, Jordi Serra, Carlos Labata, Marc Ferrer, German Cediel, Santiago Montero, Maria Jose Martínez, Helena Resta, Oriol de Diego, Joan Vila, Irene R Dégano, Roberto Elosua, Josep Lupón and Antoni Bayes-Genis Creator: LaTeX with hyperref package Producer: pdfTeX-1.40.18 CreationDate: Mon Jul 27 13:19:13 2020 CEST ModDate: Mon Jul 27 13:19:13 2020 CEST Custom Metadata: yes Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 12 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 1437778 bytes Optimized: no PDF version: 1.5 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- WVYWYS+URWPalladioL-Ital Type 1 Custom yes yes no 78 0 UDDXGE+URWPalladioL-Bold Type 1 Custom yes yes no 79 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Builtin yes yes no 415 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2024-10-02 04:25:23 CEST RepresentationInformation: jouclimed_a2020v9n8p2398.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2023-03-31 11:39:27 CEST Size: 1437778 Format: PDF Version: 1.5 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 0 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: ViewerPreferences: HideToolbar: false HideMenubar: false HideWindowUI: false FitWindow: true CenterWindow: false DisplayDocTitle: false NonFullScreenPageMode: UseNone Direction: L2R ViewArea: CropBox ViewClip: CropBox PrintArea: CropBox PageClip: CropBox PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: ぉのぴひはつふっぴどはの〠 Item: Title: きづぴとはつび〠ちのつ〠きちぴづひどちぬび〠 Children: Item: Title: こぴふつべ〠ぐはばふぬちぴどはの〠 Item: Title: くふぴっはねづび〠 Item: Title: こぴちぴどびぴどっちぬ〠ぁのちぬべびどび〠 Item: Title: げづびふぬぴび〠 Children: Item: Title: 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