Short- and long-term mortality trends in STEMI-cardiogenic shock over three decades (1989-2018): the Ruti-STEMI-shock registry

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• dc.contributor.author García-García, Cosme
• dc.contributor.author Oliveras, Teresa
• dc.contributor.author El Ouaddi, Nabil
• dc.contributor.author Rueda, Ferran
• dc.contributor.author Serra, Jordi
• dc.contributor.author Labata, Carlos
• dc.contributor.author Ferrer, Marc
• dc.contributor.author Cediel, German
• dc.contributor.author Montero, Santiago
• dc.contributor.author Martínez, María José
• dc.contributor.author Resta, Helena
• dc.contributor.author de Diego, Oriol
• dc.contributor.author Vila, Joan
• dc.contributor.author Dégano, Irene R.
• dc.contributor.author Elosua Llanos, Roberto
• dc.contributor.author Lupón, Josep
• dc.contributor.author Bayés-Genís, Antoni
• dc.date.accessioned 2020-10-05T07:18:04Z
• dc.date.available 2020-10-05T07:18:04Z
• dc.date.issued 2020
• dc.description.abstract Aims: Cardiogenic shock (CS) is an ominous complication of ST-elevation myocardial infarction (STEMI), despite the recent widespread use of reperfusion and invasive management. The Ruti-STEMI-Shock registry analysed the prevalence of and 30-day and 1-year mortality rates in ST-elevation myocardial infarction (STEMI) complicated by CS (STEMI-CS) over the last three decades. Methods and results: From February 1989 to December 2018, 493 STEMI-CS patients were consecutively admitted in a well-defined geographical area of ~850,000 inhabitants. Patients were classified into six five-year periods based on their year of admission. STEMI-CS mortality trends were analysed at 30 days and 1 year across the six strata. Cox regression analyses were performed for comparisons. Mean age was 67.5 ± 11.7 years; 69.4% were men. STEMI-CS prevalence did not decline from period 1 to 6 (7.1 vs. 6.2%, p = 0.218). Reperfusion therapy increased from 22.5% in 1989-1993 to 85.4% in 2014-2018. Thirty-day all-cause mortality declined from period 1 to 6 (65% vs. 50.5%, p < 0.001), with a 9% reduction after multivariable adjustment (HR: 0.91; 95% CI: 0.84-0.99; p = 0.024). One-year all-cause mortality declined from period 1 to 6 (67.5% vs. 57.3%, p = 0.001), with an 8% reduction after multivariable adjustment (HR: 0.92; 95% CI: 0.85-0.99; p = 0.030). Short- and long-term mortality trends in patients aged ≥ 75 years remained ~75%. Conclusions: Short- and long-term STEMI-CS-related mortality declined over the last 30 years, to ~50% of all patients. We have failed to achieve any mortality benefit in STEMI-CS patients over 75 years of age.
• dc.format.mimetype application/pdf
• dc.identifier.citation García-García C, Oliveras T, El Ouaddi N, Rueda F, Serra J, Labata C, Ferrer M, Cediel G. et al. Short- and long-term mortality trends in STEMI-cardiogenic shock over three decades (1989-2018): the Ruti-STEMI-shock registry. J Clin Med. 2020 Jul 27; 9(8):2398. DOI: 10.3390/jcm9082398
• dc.identifier.doi http://dx.doi.org/10.3390/jcm9082398
• dc.identifier.issn 2077-0383
• dc.identifier.uri http://hdl.handle.net/10230/45392
• dc.language.iso eng
• dc.publisher MDPI
• dc.rights Copyright © 2020 by the authors. 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 ST-elevation myocardial infarction
• dc.subject.keyword STEMI complications
• dc.subject.keyword STEMI mortality
• dc.subject.keyword Prognosis
• dc.title Short- and long-term mortality trends in STEMI-cardiogenic shock over three decades (1989-2018): the Ruti-STEMI-shock registry
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion