Acute cardiac care & resuscitation
Treatment Intensity for the Management of Cardiogenic Shock: Comparison Between STEMI and Non-STEMI
Authors' conclusion
Despite increasing use of inotropic and vasoactive support and mechanical circulatory support throughout the hospitalization, both patients with STEMI-CS and NSTEMI-CS remain at increased risk for in-hospital mortality.
Study context
- Population
- Adult admissions with cardiogenic shock complicating acute MI, Cardiogenic Shock Working Group
- Participants
- 1,110 patients
- Exposure
- STEMI-CS vs NSTEMI-CS
- STEMI-CSn = 731
- NSTEMI-CSn = 379reference
- Outcome
- In-hospital mortality
Methodological detailsmulticentre (17 centres)
- Multicentre (17 centres)
Main finding
As reported in the abstract
P = 0.23
- Overall in-hospital mortality
- 41%
Observational data: associations, not effects.
Further findings
Both drug and temporary mechanical circulatory support device · first 24 hours, then whole hospitalization
First 24 hours
Throughout hospitalization
- In-hospital mortality, OHCA vs no OHCA (subgroup) · NSTEMI-CS: 63% vs 36%
- P = 0.006
- In-hospital mortality, OHCA vs no OHCA (subgroup) · STEMI-CS: 52% vs 41%
- P = 0.16
- In-hospital mortality, in-hospital cardiac arrest vs none (subgroup) · STEMI-CS: 63% vs 33%
- P < 0.001
- In-hospital mortality, in-hospital cardiac arrest vs none (subgroup) · NSTEMI-CS: 60% vs 32%
- P < 0.001
- Both drug and temporary mechanical circulatory support device: P < 0.001 for both (increase over hospitalization)
Original publication
Treatment Intensity for the Management of Cardiogenic Shock: Comparison Between STEMI and Non-STEMI. JACC Adv. Published 26 May 2023. doi:10.
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