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

Elma J. Peters, Sanne ten Berg, Margriet Bogerd, Marijke J.C. Timmermans, Adriaan O. Kraaijeveld, Jeroen J.H. Bunge, Koen Teeuwen, Erik Lipsic, Krischan D. Sjauw, Robert Jan M. van Geuns, Admir Dedic, Eric A. Dubois, Martijn Meuwissen, Peter Danse, Niels J.W. Verouden, Gabe Bleeker, José M. Montero Cabezas, Irlando A. Ferreira, Annemarie E. Engström, Wim K. LagrandLuuk C. Otterspoor, Alexander P.J. Vlaar, José P.S. Henriques*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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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.

Original languageEnglish
Article number5221
JournalJournal of Clinical Medicine
Volume12
Issue number16
DOIs
Publication statusPublished - 10 Aug 2023

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© 2023 by the authors.

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