Acute cardiac care & resuscitation
Differences Between STEMI and NSTEMI Complicated by Cardiogenic Shock: Insights From a Contemporary Multilevel Registry
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
Methodological detailsmultilevel of care health system spanning 11 hospitals, multivariable analysis
- Multilevel of care health system spanning 11 hospitals
- Multivariable analysis
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