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Ten-Year (2001-2011) Trends in the Incidence Rates and Short-Term Outcomes of Early Versus Late Onset Cardiogenic Shock After Hospitalization for Acute Myocardial Infarction
University of Massachusetts Medical School Faculty Publications
  • Hoa L. Nguyen, University of Massachusetts Medical School
  • Jorge L. Yarzebski, University of Massachusetts Medical School
  • Darleen M. Lessard, University of Massachusetts Medical School
  • Joel M. Gore, Baylor Scott and White Health
  • David D. McManus, University of Massachusetts Medical School
  • Robert J. Goldberg, University of Massachusetts Medical School
UMMS Affiliation
Department of Quantitative Health Sciences; Department of Medicine
Publication Date
6-7-2017
Document Type
Article
Abstract

BACKGROUND: Cardiogenic shock (CS) is a serious complication of acute myocardial infarction, and the time of onset of CS has a potential role in influencing its prognosis. Limited contemporary data exist on this complication, however, especially from a population-based perspective. Our study objectives were to describe decade-long trends in the incidence, in-hospital mortality, and factors associated with the development of CS in 3 temporal contexts: (1) before hospital arrival for acute myocardial infarction (prehospital CS); (2) within 24 hours of hospitalization (early CS); and (3) > /=24 hours after hospitalization (late CS).

METHODS AND RESULTS: The study population consisted of 5782 patients with an acute myocardial infarction who were admitted to all 11 hospitals in central Massachusetts on a biennial basis between 2001 and 2011. The overall proportion of patients who developed CS was 5.2%. The proportion of patients with prehospital CS (1.6%) and late CS (1.5%) remained stable over time, whereas the proportion of patients with early CS declined from 2.2% in 2001-2003 to 1.2% in 2009-2011. In-hospital mortality for prehospital CS increased from 38.9% in 2001-2003 to 53.6% in 2009-2011, whereas in-hospital mortality for early and late CS decreased over time (35.9% and 64.7% in 2001-2003 to 15.8% and 39.1% in 2009-2011, respectively).

CONCLUSIONS: Development of prehospital and in-hospital CS was associated with poor short-term survival and the in-hospital death rates among those with prehospital CS increased over time. Interventions focused on preventing or treating prehospital and late CS are needed to improve in-hospital survival after acute myocardial infarction.

Keywords
  • acute myocardial infarction,
  • cardiogenic shock timing,
  • hospital prognosis,
  • population‐based study
Rights and Permissions
© 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
DOI of Published Version
10.1161/JAHA.117.005566
Source
J Am Heart Assoc. 2017 Jun 7;6(6). pii: e005566. doi: 10.1161/JAHA.117.005566. Link to article on publisher's site
Related Resources

Link to Article in PubMed

PubMed ID
28592462
Creative Commons License
Creative Commons Attribution-Noncommercial 4.0
Citation Information
Hoa L. Nguyen, Jorge L. Yarzebski, Darleen M. Lessard, Joel M. Gore, et al.. "Ten-Year (2001-2011) Trends in the Incidence Rates and Short-Term Outcomes of Early Versus Late Onset Cardiogenic Shock After Hospitalization for Acute Myocardial Infarction" Vol. 6 Iss. 6 (2017) ISSN: 2047-9980 (Linking)
Available at: http://works.bepress.com/jorge_yarzebski/114/