Cardiogenic shock complicating non-ST-segment elevation myocardial infarction: An 18-year study - 31/12/21
, Huzefa M. Bhopalwala, MBBS b, Pranathi R. Sundaragiri, MD c, Nakeya Dewaswala, MD d, Wisit Cheungpasitporn, MD e, Rajkumar Doshi, MD, MPH f, Abhiram Prasad, MD g, Gurpreet S. Sandhu, MD, PhD g, Allan S. Jaffe, MD g, Malcolm R. Bell, MD g, David R. Holmes, MD gABSTRACT |
Objective |
To evaluate the epidemiology and outcomes of non-ST-segment-elevation myocardial infarction-cardiogenic shock (NSTEMI-CS) in the United States.
Methods |
Adult (>18 years) NSTEMI-CS admissions were identified using the National Inpatient Sample (2000-2017) and classified by tertiles of admission year (2000-2005, 2006-2011 and 2012-2017). Outcomes of interest included temporal trends of prevalence and in-hospital mortality, use of cardiac procedures, in-hospital mortality, hospitalization costs, and length of stay.
Results |
In over 7.3 million NSTEMI admissions, CS was noted in 189,155 (2.6%). NSTEMI-CS increased from 1.5% in 2000 to 3.6% in 2017 (adjusted odds ratio 2.03 [95% confidence interval 1.97-2.09]; P < .001). Rates of non-cardiac organ failure and cardiac arrest increased during the study period. Between 2000 and 2017, coronary angiography (43.9%-63.9%), early coronary angiography (13.6%-25.6%), percutaneous coronary intervention (14.8%-31.6%), and coronary artery bypass grafting use (19.0%-25.8%) increased (P < .001). Over the study period, the use of intra-aortic balloon pump remained stable (28.6%-28.8%), and both percutaneous left ventricular assist devices (0%-9.1%) and extra-corporeal membrane oxygenation (0.1%-1.6%) increased (all P < .001). In hospital mortality decreased from 50.2% in 2000 to 32.3% in 2017 (adjusted odds ratio 0.27 [95% confidence interval 0.25-0.29]; P < .001). During the 18-year period, hospital lengths of stay decreased, and hospitalization costs increased.
Conclusions |
In the United States, prevalence of CS in NSTEMI has increased 2-fold between 2000 and 2017, while in-hospital mortality has decreased during the study period. Use of coronary angiography and percutaneous coronary intervention increased during the study period.
Il testo completo di questo articolo è disponibile in PDF.Abbreviations : CABG, CI, CS, ECMO, HCUP, IABP, ICD-9CM, ICD-10CM, MCS, NIS, NSTEMI, OR, PCI, pLVAD
Mappa
| Sources of Funding: Dr. Saraschandra Vallabhajosyula is supported by the Clinical and Translational Science Award (CTSA) Grant Number UL1 TR000135 from the National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health (NIH). Its contents are solely the responsibility of the authors and do not necessarily represent the official view of NIH. |
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| Disclosures: All authors have reported that they have no relationships relevant to the contents of this paper to disclose. |
Vol 244
P. 54-65 - febbraio 2022 Ritorno al numero
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