Incidence of Cardiogenic Shock in ST-Segment Elevated Myocardial Infarction

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In-hospital mortality was elevated among those who presented with cardiogenic shock during their index hospitalization.
In-hospital mortality was elevated among those who presented with cardiogenic shock during their index hospitalization.

Variation in ischemic time among patients with ST-segment elevation myocardial infarction (STEMI) can affect the incidence of cardiogenic shock mortality, according to research presented at the 66th Annual Scientific Session & Expo of the American College of Cardiology.

Researchers from the Loma Linda University Medical Center in California conducted a retrospective study of data from 766 patients who presented with STEMI to a tertiary care university medical center between 2008 and 2015. Researchers used 2 sample t-tests to compare ischemic time in patients with (n=56) and without a cardiogenic shock diagnosis; a chi-squared test was used to compare in-hospital mortality between both groups.

 

Incidence of cardiogenic shock was not affected by ischemic time (P =.75), although patients with cardiogenic shock during index hospitalization experienced significantly higher mortality rates (34% vs 4%; P <.001). Patients presenting with syncope were at an increased risk for cardiogenic shock (odds ratio [OR], 4.9; 95% CI, 1.50-15.81); conversely, patients presenting with chest pain were at a decreased risk (OR, 0.27; 95% CI, 0.15-0.49).

One identified risk factor for cardiogenic shock included elevated body mass index (BMI), with a 6.7% increased risk for every unit of BMI greater than 25 kg/m2 (95% CI, 1.012-1.126). Female sex was found to decrease cardiogenic shock risk by 45% (95% CI, 0.304-1.002).

The researchers noted that additional studies would be needed to "further evaluate the mechanism between ischemic time and risk factors associated with [cardiogenic shock]."

Reference

Amponsah D, Khachatryan T, Hamilton D, et al. Ischemic time and risk factors associated with the incidence of cardiogenic shock in patients presenting with ST elevation myocardial infarction. Abstract 1126-330. Presented at: 66th Annual Scientific Session & Expo of the American College of Cardiology. March 17-19, 2017; Washington, DC. 

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