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

• Published in: Journal of clinical medicine Vol. 12; no. 16; p. 5221
• Main Authors: Peters, Elma J., Berg, Sanne ten, Bogerd, Margriet, Timmermans, Marijke J. C., Kraaijeveld, Adriaan O., Bunge, Jeroen J. H., Teeuwen, Koen, Lipsic, Erik, Sjauw, Krischan D., Geuns, Robert-Jan M. van, Dedic, Admir, Dubois, Eric A., Meuwissen, Martijn, Danse, Peter, Verouden, Niels J. W., Bleeker, Gabe, Cabezas, José M. Montero, Ferreira, Irlando A., Engström, Annemarie E., Lagrand, Wim K., Otterspoor, Luuk C., Vlaar, Alexander P. J., Henriques, José P. S.
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 10.08.2023; MDPI
• Subjects: Blood pressure; Cardiogenic shock; Care and treatment; Clinical medicine; Complications and side effects; Data collection; Diabetes; Diagnosis; Heart attack; Heart attacks; Hospitals; Hypotension; Missing data; Mortality; Patient outcomes; Patients; Statistical analysis; Transluminal angioplasty; Trends; Variables; Veins & arteries; Netherlands; mortality; percutaneous coronary intervention; cardiogenic shock; evidence-based therapy; acute myocardial infarction
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm12165221

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.