Cardiogenic shock complicating non-ST-segment elevation myocardial infarction: An 18-year study.

Autor: Vallabhajosyula S; Section of Cardiovascular Medicine, Department of Medicine, Wake Forest University School of Medicine, Winston-Salem, NC. Electronic address: svallabh@wakehealth.edu., Bhopalwala HM; Department of Medicine, Appalachian Regional Healthcare, Whitesburg, KY., Sundaragiri PR; Department of Primary Care Internal Medicine, Wake Forest Baptist Health, High Point, NC., Dewaswala N; Division of Cardiovascular Medicine, Department of Medicine, University of Kentucky College of Medicine, Lexington, KY., Cheungpasitporn W; Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN., Doshi R; Division of Cardiovascular Medicine, Department of Medicine, Saint Joseph University Medical Center, Paterson, NJ., Prasad A; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN., Sandhu GS; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN., Jaffe AS; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN., Bell MR; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN., Holmes DR Jr; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN.
Jazyk: angličtina
Zdroj: American heart journal [Am Heart J] 2022 Feb; Vol. 244, pp. 54-65. Date of Electronic Publication: 2021 Nov 11.
DOI: 10.1016/j.ahj.2021.11.002
Abstrakt: Objective: To evaluate the epidemiology and outcomes of non-ST-segment-elevation myocardial infarction-cardiogenic shock (NSTEMI-CS) in the United States.
Methods: Adult (>18 years) NSTEMI-CS admissions were identified using the National Inpatient Sample (2000-2017) and classified by tertiles of admission year (2000-2005, 2006-2011 and 2012-2017). Outcomes of interest included temporal trends of prevalence and in-hospital mortality, use of cardiac procedures, in-hospital mortality, hospitalization costs, and length of stay.
Results: In over 7.3 million NSTEMI admissions, CS was noted in 189,155 (2.6%). NSTEMI-CS increased from 1.5% in 2000 to 3.6% in 2017 (adjusted odds ratio 2.03 [95% confidence interval 1.97-2.09]; P < .001). Rates of non-cardiac organ failure and cardiac arrest increased during the study period. Between 2000 and 2017, coronary angiography (43.9%-63.9%), early coronary angiography (13.6%-25.6%), percutaneous coronary intervention (14.8%-31.6%), and coronary artery bypass grafting use (19.0%-25.8%) increased (P < .001). Over the study period, the use of intra-aortic balloon pump remained stable (28.6%-28.8%), and both percutaneous left ventricular assist devices (0%-9.1%) and extra-corporeal membrane oxygenation (0.1%-1.6%) increased (all P < .001). In hospital mortality decreased from 50.2% in 2000 to 32.3% in 2017 (adjusted odds ratio 0.27 [95% confidence interval 0.25-0.29]; P < .001). During the 18-year period, hospital lengths of stay decreased, and hospitalization costs increased.
Conclusions: In the United States, prevalence of CS in NSTEMI has increased 2-fold between 2000 and 2017, while in-hospital mortality has decreased during the study period. Use of coronary angiography and percutaneous coronary intervention increased during the study period.
(Copyright © 2021 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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