Non-STEMI vs. STEMI Cardiogenic Shock : Clinical Profile and Long-Term Outcomes
Martínez, María José (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Rueda, Ferran (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Labata, Carlos (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Oliveras, Teresa (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Montero, Santiago (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Ferrer Vinardel, Marc (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)
Serra, Jordi (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
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)
Garcia Garcia, Cosme (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Universitat Autònoma de Barcelona

Date:	2022
Abstract:	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.
Rights:	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.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Cardiogenic shock ; NSTEMI ; Prognosis ; STEMI
Published in:	Journal of clinical medicine, Vol. 11 (june 2022) , ISSN 2077-0383

DOI: 10.3390/jcm11123558
PMID: 35743628

11 p, 850.5 KB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
Articles > Research articles
Articles > Published articles