Acute cardiac care & resuscitation
Shock Timing in STEMI-CS: Management and Outcomes in a Resource-Limited Setting
Authors' conclusion
PRC patients presented with greater severity, received less inpatient best available medical therapy, and had higher unadjusted mortality. However, in the multivariable logistic regression model, shock timing was not statistically significantly associated with mortality.
Study context
- Population
- Patients with cardiogenic shock complicating STEMI, from a registry of patients with STEMI admitted to 4 Cuban hospitalsdeveloped cardiogenic shock, among 4,113 patients with STEMI
- Participants
- 435 patients
- Exposure
- Shock onset before vs after arrival at a reperfusion center
- PRCn = 134
- A reperfusion center (ARC)n = 301reference
- Outcome
- Clinical severity (systolic blood pressure, left ventricular ejection fraction, renal function, Global Registry of Acute Coronary Events scores)
Methodological detailsmulticenter registry (RECUIMA), 4 Cuban hospitals
- Multicenter registry (RECUIMA)
- 4 Cuban hospitals
Main finding
As reported in the abstract
- PRC patients had greater clinical severity, including lower systolic blood pressure and left ventricular ejection fraction, worse renal function, and higher Global Registry of Acute Coronary Events scores
- all P < 0.01
Observational data: associations, not effects.
Further findings
| Outcome | PRC | ARC | Estimate | P value | |
|---|---|---|---|---|---|
| Inpatient best available medical therapy | 32.8% | 51.8% | relative risk 0.63 (95% CI 0.49–0.83) | P < 0.001 | |
| Unadjusted in-hospital mortality | 50.0% | 38.2% | relative risk 1.31 (95% CI 1.05–1.63) | P = 0.021 | |
| Mortality, multivariable logistic regressionMultivariable adjusted | OR 1.65 (95% CI 0.86–3.18) | P = 0.13 | |||
| 0.20.5125Ratio (log scale) |
- Mortality, multivariable logistic regression: shock timing not statistically significantly associated with mortality
Original publication
Shock Timing in STEMI-CS: Management and Outcomes in a Resource-Limited Setting. JACC Adv. Published September 2026. doi:10.
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