Non-STEMI vs. STEMI Cardiogenic Shock

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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Detalles Bibliográficos
Autores: Martínez, María José, Rueda, Ferran|||0000-0001-5464-4870, Labata, Carlos|||0000-0002-4505-0787, Oliveras, Teresa, Montero, Santiago|||0000-0002-0984-3472, Ferrer Vinardel, Marc|||0000-0002-1283-8578, El Ouaddi, Nabil|||0000-0002-5980-8915, Serra Flores, Jordi, Lupón, Josep|||0000-0002-5601-9611, Bayés-Genís, Antoni|||0000-0002-3044-197X, Garcia Garcia, Cosme|||0000-0001-6330-1677
Tipo de recurso: artículo
Fecha de publicación:2022
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:282789
Acceso en línea:https://ddd.uab.cat/record/282789
https://dx.doi.org/urn:doi:10.3390/jcm11123558
Access Level:acceso abierto
Palabra clave:Cardiogenic shock
NSTEMI
Prognosis
STEMI
Descripción
Sumario: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.

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