d1bb02e93a36939d5897481ea9d98f2b pmc_9224589.pdf 146023b56a7fe01469ae0a09bb6fb341a95cea60 pmc_9224589.pdf ad98a243b9c216227191397c97d9be50056e209e00aa2c851778c3880d098747 pmc_9224589.pdf Title: Non-STEMI vs. STEMI Cardiogenic Shock: Clinical Profile and Long-Term Outcomes Subject: Cardiogenic shock (CS) is a severe complication of acute myocardial infarction (AMI). In AMI-CS, the ST segment deviation on ECG may be elevated (STEMI-CS) or non-elevated (NSTEMI-CS), which may influence prognosis. Our aim was to analyze the clinical profile, acute-phase prognosis, and long-term outcomes of CS relative to the ST pattern on admission. In a prospective registry of 4647 AMI patients admitted to the intensive cardiac care unit of a university hospital between 2010 and 2019, we compared the clinical characteristics, 30-days case fatality, and long-term outcomes of AMI-CS, based on the presence of ST-segment deviation. AMI-CS developed in 239 (5.1%) patients (26.4% women): 190 (79.5%) STEMI-CS and 49 (20.5%) NSTEMI-CS. The mean age was 69.7 years. The STEMI-CS patients had larger infarcts and more mechanical complications than the NSTEMI-CS patients. The NSTEMI-CS patients had a greater prevalence of hypertension, diabetes, peripheral vascular disease, previous cardiovascular comorbidities, three-vessel disease, and left main disease than the STEMI-CS patients. The STEMI-CS patients had higher 30-day mortality than the NSTEMI-CS (59.5% vs. 36.7%; p = 0.004), even after multivariable adjustment (HR 1.91; 95% CI 1.16–3.14), but no differences in mortality were observed at 3 years. In conclusion, the 30-day case-fatality is higher in STEMI-CS, but the long-term outcome is similar in both groups. Keywords: STEMI; NSTEMI; cardiogenic shock; prognosis Author: María José Martínez, Ferran Rueda, Carlos Labata, Teresa Oliveras, Santiago Montero, Marc Ferrer, Nabil El Ouaddi, Jordi Serra, Josep Lupón, Antoni Bayés-Genís and Cosme García-García Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Tue Jun 21 08:51:39 2022 CEST ModDate: Tue Jun 21 09:09:59 2022 CEST Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 11 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 870920 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- MZYQTD+URWPalladioL-Bold Type 1 Custom yes yes no 10 0 IABZFC+URWPalladioL-Roma Type 1 Custom yes yes no 15 0 GPVDBQ+URWPalladioL-Ital Type 1 Custom yes yes no 19 0 XWOCXD+VnURWPalladioL-Bold Type 1 Custom yes yes no 23 0 XPUSBJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 42 0 BSDWLC+TimesNewRomanPSMT Type 1C WinAnsi yes yes no 45 0 IKKWKP+CMSY10 Type 1 Builtin yes yes no 67 0 RHAWTP+EURM10 Type 1 Builtin yes yes no 71 0 QLBIEB+URWPalladioL-BoldItal Type 1 Custom yes yes no 81 0 BCDEEE+PalatinoLinotype-Bold TrueType WinAnsi yes yes no 99 0 BCDFEE+PalatinoLinotype-Roman TrueType WinAnsi yes yes no 103 0 BCDGEE+PalatinoLinotype-Italic TrueType WinAnsi yes yes no 107 0 BCDHEE+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 111 0 BCDEEE+PalatinoLinotype-Bold TrueType WinAnsi yes yes no 127 0 BCDFEE+PalatinoLinotype-Roman TrueType WinAnsi yes yes no 131 0 BCDGEE+PalatinoLinotype-Italic TrueType WinAnsi yes yes no 135 0 BCDHEE+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 139 0 BAMNYG+VnURWPalladioL Type 1 Custom yes yes no 153 0 Jhove (Rel. 1.22.1, 2019-04-17) Date: 2023-09-28 02:34:42 CEST RepresentationInformation: pmc_9224589.pdf ReportingModule: PDF-hul, Rel. 1.12.1 (2019-04-17) LastModified: 2023-09-27 02:17:38 CEST Size: 870920 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 262 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@262b2c86 Item: Title: Materials and Methods Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@371a67ec Children: Item: Title: Study Population and Data Collection Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@5ed828d Item: Title: Statistical Analysis Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@50d0686 Item: Title: Results Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7a3d45bd Children: Item: Title: Clinical Profile Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@1e7c7811 Item: Title: Outcomes Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@77ec78b9 Item: Title: Discussion Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@1a3869f4 Item: Title: Conclusions Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@a38d7a3 Item: Title: References Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@77f99a05 Info: Title: Non-STEMI vs. STEMI Cardiogenic Shock: Clinical Profile and Long-Term Outcomes Author: María José Martínez, Ferran Rueda, Carlos Labata, Teresa Oliveras, Santiago Montero, Marc Ferrer, Nabil El Ouaddi, Jordi Serra, Josep Lupón, Antoni Bayés-Genís and Cosme García-García Subject: Cardiogenic shock (CS) is a severe complication of acute myocardial infarction (AMI). In AMI-CS, the ST segment deviation on ECG may be elevated (STEMI-CS) or non-elevated (NSTEMI-CS), which may influence prognosis. Our aim was to analyze the clinical profile, acute-phase prognosis, and long-term outcomes of CS relative to the ST pattern on admission. In a prospective registry of 4647 AMI patients admitted to the intensive cardiac care unit of a university hospital between 2010 and 2019, we compared the clinical characteristics, 30-days case fatality, and long-term outcomes of AMI-CS, based on the presence of ST-segment deviation. AMI-CS developed in 239 (5.1%) patients (26.4% women): 190 (79.5%) STEMI-CS and 49 (20.5%) NSTEMI-CS. The mean age was 69.7 years. The STEMI-CS patients had larger infarcts and more mechanical complications than the NSTEMI-CS patients. The NSTEMI-CS patients had a greater prevalence of hypertension, diabetes, peripheral vascular disease, previous cardiovascular comorbidities, three-vessel disease, and left main disease than the STEMI-CS patients. The STEMI-CS patients had higher 30-day mortality than the NSTEMI-CS (59.5% vs. 36.7%; p = 0.004), even after multivariable adjustment (HR 1.91; 95% CI 1.16 3.14), but no differences in mortality were observed at 3 years. In conclusion, the 30-day case-fatality is higher in STEMI-CS, but the long-term outcome is similar in both groups. 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