Skip to main content
Article
Temporal trends in cardiogenic shock complicating acute myocardial infarction
Open Access Articles
  • Robert J. Goldberg, University of Massachusetts Medical School
  • Navid A. Samad
  • Jorge L. Yarzebski, University of Massachusetts Medical School
  • Jerry H. Gurwitz, University of Massachusetts Medical School
  • Carol Bigelow, University of Massachusetts, Amherst
  • Joel M. Gore, University of Massachusetts Medical School
UMMS Affiliation
Department of Medicine, Division of Cardiovascular Medicine
Date
4-15-1999
Document Type
Article
Subjects
Aged; Female; Hospital Mortality; Hospitals, Community; Hospitals, Teaching; Humans; Incidence; Logistic Models; Male; Massachusetts; Middle Aged; Myocardial Infarction; Myocardial Reperfusion; Risk Factors; Shock, Cardiogenic; Survival Rate
Abstract

BACKGROUND: Limited information is available on trends in the incidence of and mortality due to cardiogenic shock complicating acute myocardial infarction. We studied the incidence of cardiogenic shock complicating acute myocardial infarction and in-hospital death rates among patients with this condition in a single community from 1975 through 1997. METHODS: We conducted an observational study of 9076 residents of metropolitan Worcester, Massachusetts, who were hospitalized with confirmed acute myocardial infarction in all local hospitals during 11 one-year periods between 1975 and 1997. Our study included periods before and after the advent of reperfusion therapy. RESULTS: The incidence of cardiogenic shock remained relatively stable over time, averaging 7.1 percent among patients with acute myocardial infarction. The results of a multivariable regression analysis indicated that the patients hospitalized during recent study years were not at a substantially lower risk for shock than patients hospitalized in the mid-to-late 1970s. Patients in whom cardiogenic shock developed had a significantly greater risk of dying during hospitalization (71.7 percent) than those who did not have cardiogenic shock (12.0 percent, P<0.001). A significant trend toward an increase in in-hospital survival among patients with cardiogenic shock in the mid-to-late 1990s was found in crude and adjusted analyses. CONCLUSIONS: Our findings indicate no significant change in the incidence of cardiogenic shock complicating acute myocardial infarction over a 23-year period. However, the short-term survival rate has increased in recent years at the same time as the use of coronary reperfusion strategies has increased.

Rights and Permissions
Citation: N Engl J Med. 1999 Apr 15;340(15):1162-8.
Related Resources
Link to Article in PubMed
PubMed ID
10202167
Citation Information
Robert J. Goldberg, Navid A. Samad, Jorge L. Yarzebski, Jerry H. Gurwitz, et al.. "Temporal trends in cardiogenic shock complicating acute myocardial infarction" Vol. 340 Iss. 15 (1999) ISSN: 0028-4793 (Print)
Available at: http://works.bepress.com/jorge_yarzebski/19/