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. 2023 Aug 10;12(16):5221.
doi: 10.3390/jcm12165221.

Characteristics, Treatment Strategies and Outcome in Cardiogenic Shock Complicating Acute Myocardial Infarction: A Contemporary Dutch Cohort

Elma J Peters  1 , Sanne Ten Berg  1 , Margriet Bogerd  1 , Marijke J C Timmermans  2 , Adriaan O Kraaijeveld  3 , Jeroen J H Bunge  4   5 , Koen Teeuwen  6 , Erik Lipsic  7 , Krischan D Sjauw  8 , Robert-Jan M van Geuns  9 , Admir Dedic  10 , Eric A Dubois  4   5 , Martijn Meuwissen  11 , Peter Danse  12 , Niels J W Verouden  1 , Gabe Bleeker  13 , José M Montero Cabezas  14 , Irlando A Ferreira  15 , Annemarie E Engström  16 , Wim K Lagrand  16 , Luuk C Otterspoor  5   17 , Alexander P J Vlaar  16 , José P S Henriques  1 , On Behalf Of The Participating Centers Of The Pci Registration Committee Of The Netherlands Heart Registration
Affiliations

Characteristics, Treatment Strategies and Outcome in Cardiogenic Shock Complicating Acute Myocardial Infarction: A Contemporary Dutch Cohort

Elma J Peters et al. J Clin Med. .

Abstract

Cardiogenic shock (CS) complicating acute myocardial infarction (AMI) is associated with high morbidity and mortality. Our study aimed to gain insights into patient characteristics, outcomes and treatment strategies in CS patients. Patients with CS who underwent percutaneous coronary intervention (PCI) between 2017 and 2021 were identified in a nationwide registry. Data on medical history, laboratory values, angiographic features and outcomes were retrospectively assessed. A total of 2328 patients with a mean age of 66 years and of whom 73% were male, were included. Mortality at 30 days was 39% for the entire cohort. Non-survivors presented with a lower mean blood pressure and increased heart rate, blood lactate and blood glucose levels (p-value for all <0.001). Also, an increased prevalence of diabetes, multivessel coronary artery disease and a prior coronary event were found. Of all patients, 24% received mechanical circulatory support, of which the majority was via intra-aortic balloon pumps (IABPs). Furthermore, 79% of patients were treated with at least one vasoactive agent, and multivessel PCI was performed in 28%. In conclusion, a large set of hemodynamic, biochemical and patient-related characteristics was identified to be associated with mortality. Interestingly, multivessel PCI and IABPs were frequently applied despite a lack of evidence.

Keywords: acute myocardial infarction; cardiogenic shock; evidence-based therapy; mortality; percutaneous coronary intervention.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure A1
Figure A1
Final variable selection. A total of 53 variables were selected for the final registry, that can be found in Table A1 and Table A3 together with its corresponding data dictionary. Percentages of missing data are shown per variable and were higher in in the additionally collected shock variables than in the standard PCI variables.
Figure 1
Figure 1
Percentage of multivessel PCIs during index procedure within patients with multivessel disease.
Figure 2
Figure 2
Use of mechanical circulatory support.
Figure 3
Figure 3
Yearly trend in 30-day and 1-year mortality.
Figure 4
Figure 4
Survival curves for (a) males and females; (b) OHCA yes or no; (c) STEMI and NSTEMI; (d) multivessel and single-vessel PCI.
See this image and copyright information in PMC

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