eScholarship@UMMS

Title

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

Authors

Hoa L. Nguyen, University of Massachusetts Medical SchoolFollow
Jorge L. Yarzebski, University of Massachusetts Medical SchoolFollow
Darleen M. Lessard, University of Massachusetts Medical SchoolFollow
Joel M. Gore, University of Massachusetts Medical SchoolFollow
David D. McManus, University of Massachusetts Medical SchoolFollow
Robert J. Goldberg, University of Massachusetts Medical SchoolFollow

UMMS Affiliation

Department of Quantitative Health Sciences; Department of Medicine, Division of Cardiovascular Medicine

Publication Date

6-7-2017

Document Type

Article

Disciplines

Cardiology | Cardiovascular Diseases | Clinical Epidemiology | Epidemiology

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.

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

Journal/Book/Conference Title

Journal of the American Heart Association

Related Resources

Link to Article in PubMed

PubMed ID

28592462

Repository Citation

Nguyen, Hoa L.; Yarzebski, Jorge L.; Lessard, Darleen M.; Gore, Joel M.; McManus, David D.; and Goldberg, Robert J., "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" (2017). Open Access Articles. 3185.
https://escholarship.umassmed.edu/oapubs/3185

Creative Commons License

This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License