Short- and Long-Term Mortality Trends in STEMI-Cardiogenic Shock over Three Decades (1989-2018): the Ruti-STEMI-Shock Registry
Garcia Garcia, Cosme (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Oliveras, Teresa (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
El Ouaddi, Nabil (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Rueda, Ferran (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Serra Flores, Jordi (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Labata, Carlos (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Ferrer Massot, Marc (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Cediel, Germán (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Montero, Santiago (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Martínez, Maria Jose (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Resta, Helena (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
De Diego, Oriol (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Vila, Joan (Institut Hospital del Mar d'Investigacions Mèdiques)
Degano, Irene R. (Institut Hospital del Mar d'Investigacions Mèdiques)
Elosua, Roberto (Institut Hospital del Mar d'Investigacions Mèdiques)
Lupón, Josep (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Bayés-Genís, Antoni (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Universitat Autònoma de Barcelona. Departament de Medicina

Data:	2020
Resum:	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.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	ST-elevation myocardial infarction ; Prognosis ; STEMI complications ; STEMI mortality
Publicat a:	Journal of clinical medicine, Vol. 9 Núm. 8 (2020) , p. 2398, ISSN 2077-0383

DOI: 10.3390/jcm9082398
PMID: 32727034

12 p, 1.4 MB

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Documents de recerca > Documents dels grups de recerca de la UAB > Centres i grups de recerca (producció científica) > Ciències de la salut i biociències > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
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