Non-STEMI vs. STEMI cardiogenic shock: clinical profile and long-term outcomes

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• dc.contributor.author Martínez, María José
• dc.contributor.author Rueda, Ferran
• dc.contributor.author Labata, Carlos
• dc.contributor.author Oliveras, Teresa
• dc.contributor.author Montero, Santiago
• dc.contributor.author Ferrer, Marc
• dc.contributor.author Ferrer, Marc
• dc.contributor.author El Ouaddi, Nabil
• dc.contributor.author Serra, Jordi
• dc.contributor.author Lupón, Josep
• dc.contributor.author Bayés-Genís, Antoni
• dc.contributor.author García-García, Cosme
• dc.date.accessioned 2022-11-17T07:52:49Z
• dc.date.available 2022-11-17T07:52:49Z
• dc.date.issued 2022
• dc.description.abstract Cardiogenic shock (CS) is a severe complication of acute myocardial infarction (AMI). In AMI-CS, the ST segment deviation on ECG may be elevated (STEMI-CS) or non-elevated (NSTEMI-CS), which may influence prognosis. Our aim was to analyze the clinical profile, acute-phase prognosis, and long-term outcomes of CS relative to the ST pattern on admission. In a prospective registry of 4647 AMI patients admitted to the intensive cardiac care unit of a university hospital between 2010 and 2019, we compared the clinical characteristics, 30-days case fatality, and long-term outcomes of AMI-CS, based on the presence of ST-segment deviation. AMI-CS developed in 239 (5.1%) patients (26.4% women): 190 (79.5%) STEMI-CS and 49 (20.5%) NSTEMI-CS. The mean age was 69.7 years. The STEMI-CS patients had larger infarcts and more mechanical complications than the NSTEMI-CS patients. The NSTEMI-CS patients had a greater prevalence of hypertension, diabetes, peripheral vascular disease, previous cardiovascular comorbidities, three-vessel disease, and left main disease than the STEMI-CS patients. The STEMI-CS patients had higher 30-day mortality than the NSTEMI-CS (59.5% vs. 36.7%; p = 0.004), even after multivariable adjustment (HR 1.91; 95% CI 1.16-3.14), but no differences in mortality were observed at 3 years. In conclusion, the 30-day case-fatality is higher in STEMI-CS, but the long-term outcome is similar in both groups.
• dc.format.mimetype application/pdf
• dc.identifier.citation Martínez MJ, Rueda F, Labata C, Oliveras T, Montero S, Ferrer M, et al. Non-STEMI vs. STEMI cardiogenic shock: clinical profile and long-term outcomes. J Clin Med. 2022 Jun 20; 11(12): 3558. DOI: 10.3390/jcm11123558
• dc.identifier.doi http://dx.doi.org/10.3390/jcm11123558
• dc.identifier.issn 2077-0383
• dc.identifier.uri http://hdl.handle.net/10230/54904
• dc.language.iso eng
• dc.publisher MDPI
• dc.rights Copyright © 2022 by Martínez MJ, Rueda F, Labata C, Oliveras T, Montero S, Ferrer M, et al. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by/4.0/
• dc.subject.keyword NSTEMI
• dc.subject.keyword STEMI
• dc.subject.keyword Cardiogenic shock
• dc.subject.keyword Prognosis
• dc.title Non-STEMI vs. STEMI cardiogenic shock: clinical profile and long-term outcomes
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion