Non-STEMI vs. STEMI cardiogenic shock: clinical profile and long-term outcomes

Cardiogenic shock (CS) is a severe complication of acute myocardial infarction (AMI). In AMI-CS, the ST segment deviation on ECG may be elevated (STEMI-CS) or non-elevated (NSTEMI-CS), which may influence prognosis. Our aim was to analyze the clinical profile, acute-phase prognosis, and long-term ou...

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Autores: Martínez, María José, Rueda, Ferran, Labata, Carlos, Oliveras, Teresa, Montero, Santiago, Ferrer, Marc, El Ouaddi, Nabil, Serra, Jordi, Lupón, Josep, Bayés-Genís, Antoni, García-García, Cosme
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2022
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:10230/54904
Acceso en línea:http://hdl.handle.net/10230/54904
http://dx.doi.org/10.3390/jcm11123558
Access Level:acceso abierto
Palabra clave:NSTEMI
STEMI
Cardiogenic shock
Prognosis
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spelling Non-STEMI vs. STEMI cardiogenic shock: clinical profile and long-term outcomesMartínez, María JoséRueda, FerranLabata, CarlosOliveras, TeresaMontero, SantiagoFerrer, MarcFerrer, MarcEl Ouaddi, NabilSerra, JordiLupón, JosepBayés-Genís, AntoniGarcía-García, CosmeNSTEMISTEMICardiogenic shockPrognosisCardiogenic shock (CS) is a severe complication of acute myocardial infarction (AMI). In AMI-CS, the ST segment deviation on ECG may be elevated (STEMI-CS) or non-elevated (NSTEMI-CS), which may influence prognosis. Our aim was to analyze the clinical profile, acute-phase prognosis, and long-term outcomes of CS relative to the ST pattern on admission. In a prospective registry of 4647 AMI patients admitted to the intensive cardiac care unit of a university hospital between 2010 and 2019, we compared the clinical characteristics, 30-days case fatality, and long-term outcomes of AMI-CS, based on the presence of ST-segment deviation. AMI-CS developed in 239 (5.1%) patients (26.4% women): 190 (79.5%) STEMI-CS and 49 (20.5%) NSTEMI-CS. The mean age was 69.7 years. The STEMI-CS patients had larger infarcts and more mechanical complications than the NSTEMI-CS patients. The NSTEMI-CS patients had a greater prevalence of hypertension, diabetes, peripheral vascular disease, previous cardiovascular comorbidities, three-vessel disease, and left main disease than the STEMI-CS patients. The STEMI-CS patients had higher 30-day mortality than the NSTEMI-CS (59.5% vs. 36.7%; p = 0.004), even after multivariable adjustment (HR 1.91; 95% CI 1.16-3.14), but no differences in mortality were observed at 3 years. In conclusion, the 30-day case-fatality is higher in STEMI-CS, but the long-term outcome is similar in both groups.MDPI202220222022info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/54904http://dx.doi.org/10.3390/jcm11123558reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésCopyright © 2022 by Martínez MJ, Rueda F, Labata C, Oliveras T, Montero S, Ferrer M, et al. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).http://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:recercat.cat:10230/549042026-05-29T05:05:01Z
dc.title.none.fl_str_mv Non-STEMI vs. STEMI cardiogenic shock: clinical profile and long-term outcomes
title Non-STEMI vs. STEMI cardiogenic shock: clinical profile and long-term outcomes
spellingShingle Non-STEMI vs. STEMI cardiogenic shock: clinical profile and long-term outcomes
Martínez, María José
NSTEMI
STEMI
Cardiogenic shock
Prognosis
title_short Non-STEMI vs. STEMI cardiogenic shock: clinical profile and long-term outcomes
title_full Non-STEMI vs. STEMI cardiogenic shock: clinical profile and long-term outcomes
title_fullStr Non-STEMI vs. STEMI cardiogenic shock: clinical profile and long-term outcomes
title_full_unstemmed Non-STEMI vs. STEMI cardiogenic shock: clinical profile and long-term outcomes
title_sort Non-STEMI vs. STEMI cardiogenic shock: clinical profile and long-term outcomes
dc.creator.none.fl_str_mv Martínez, María José
Rueda, Ferran
Labata, Carlos
Oliveras, Teresa
Montero, Santiago
Ferrer, Marc
Ferrer, Marc
El Ouaddi, Nabil
Serra, Jordi
Lupón, Josep
Bayés-Genís, Antoni
García-García, Cosme
author Martínez, María José
author_facet Martínez, María José
Rueda, Ferran
Labata, Carlos
Oliveras, Teresa
Montero, Santiago
Ferrer, Marc
El Ouaddi, Nabil
Serra, Jordi
Lupón, Josep
Bayés-Genís, Antoni
García-García, Cosme
author_role author
author2 Rueda, Ferran
Labata, Carlos
Oliveras, Teresa
Montero, Santiago
Ferrer, Marc
El Ouaddi, Nabil
Serra, Jordi
Lupón, Josep
Bayés-Genís, Antoni
García-García, Cosme
author2_role author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv NSTEMI
STEMI
Cardiogenic shock
Prognosis
topic NSTEMI
STEMI
Cardiogenic shock
Prognosis
description Cardiogenic shock (CS) is a severe complication of acute myocardial infarction (AMI). In AMI-CS, the ST segment deviation on ECG may be elevated (STEMI-CS) or non-elevated (NSTEMI-CS), which may influence prognosis. Our aim was to analyze the clinical profile, acute-phase prognosis, and long-term outcomes of CS relative to the ST pattern on admission. In a prospective registry of 4647 AMI patients admitted to the intensive cardiac care unit of a university hospital between 2010 and 2019, we compared the clinical characteristics, 30-days case fatality, and long-term outcomes of AMI-CS, based on the presence of ST-segment deviation. AMI-CS developed in 239 (5.1%) patients (26.4% women): 190 (79.5%) STEMI-CS and 49 (20.5%) NSTEMI-CS. The mean age was 69.7 years. The STEMI-CS patients had larger infarcts and more mechanical complications than the NSTEMI-CS patients. The NSTEMI-CS patients had a greater prevalence of hypertension, diabetes, peripheral vascular disease, previous cardiovascular comorbidities, three-vessel disease, and left main disease than the STEMI-CS patients. The STEMI-CS patients had higher 30-day mortality than the NSTEMI-CS (59.5% vs. 36.7%; p = 0.004), even after multivariable adjustment (HR 1.91; 95% CI 1.16-3.14), but no differences in mortality were observed at 3 years. In conclusion, the 30-day case-fatality is higher in STEMI-CS, but the long-term outcome is similar in both groups.
publishDate 2022
dc.date.none.fl_str_mv 2022
2022
2022
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10230/54904
http://dx.doi.org/10.3390/jcm11123558
url http://hdl.handle.net/10230/54904
http://dx.doi.org/10.3390/jcm11123558
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv http://creativecommons.org/licenses/by/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv MDPI
publisher.none.fl_str_mv MDPI
dc.source.none.fl_str_mv reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
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