Acute cardiac care & resuscitation
Differences Between STEMI and NSTEMI Complicated by Cardiogenic Shock
- Cohort study
- multilevel of care health system spanning 11 hospitals
- multivariable analysis
+2 more
- multilevel of care health system spanning 11 hospitals
- multivariable analysis
Authors' conclusion
STEMI and NSTEMI patients with CS have distinct clinical profiles and management strategies across all hospital levels. Although they experience similar rates of short and long-term mortality, associations between mechanical circulatory support use and outcomes differ by phenotype. These findings suggest that AMI type should inform management strategies and research design in CS.
Study context
- Population
- Adults treated for cardiogenic shock due to STEMI or NSTEMI, 2016 to 2022patients identified
- Participants
- 1,375 adults
- Exposure
- Cardiogenic shock (CS) due to acute myocardial infarction (AMI) with and without ST-segment elevation
- STEMI-CSn = 57%
- Non-STEMI-CS (NSTEMI-CS)n = 43%
- Outcome
- All-cause mortality
- Follow-up
- 6-month
Main finding
As reported in the abstract
P = 0.53
Observational data: associations, not effects.
Secondary outcomes
Management in those undergoing left heart catheterization
Coronary artery bypass grafting
Percutaneous coronary intervention
In-hospital all-cause mortality
- Similar in both groups
Management in those undergoing left heart catheterization
- Management patterns were consistent across hospital levels
Associations with 6-month mortality (multivariable analysis)
- Revascularization associated with lower 6-month mortality in both groups
- Intra-aortic balloon pump or percutaneous ventricular assist device use associated with lower mortality only in STEMI-CS
- Venoarterial extracorporeal membrane oxygenation associated with increased mortality in both AMI types
Original publication
Summarised from the published abstract; every number is checked against it