Long-term outcome in early survivors of cardiogenic shock at the acute stage of myocardial infarction: a landmark analysis from the French registry of Acute ST-elevation and non-ST-elevation Myocardial Infarction (FAST-MI) Registry

Nadia Aissaoui, Etienne Puymirat, Tabassome Simon, Eric Bonnefoy-Cudraz, Denis Angoulvant, Francois Schiele, Hakim Benamer, Philippe Quandalle, Fabrice Prunier, Eric Durand, Laurence Berard, Didier Blanchard, Nicolas Danchin, Nadia Aissaoui, Etienne Puymirat, Tabassome Simon, Eric Bonnefoy-Cudraz, Denis Angoulvant, Francois Schiele, Hakim Benamer, Philippe Quandalle, Fabrice Prunier, Eric Durand, Laurence Berard, Didier Blanchard, Nicolas Danchin

Abstract

Introduction: There are little data about patients with cardiogenic shock (CS) who survive the early phase of acute myocardial infarction (AMI). The aim of this study was to assess long-term (5-year) mortality among early survivors of AMI, according to the presence of CS at the acute stage.

Methods: We analyzed 5-year follow-up data from the French registry of Acute ST-elevation and non-ST-elevation Myocardial Infarction (FAST-MI) 2005 registry, a nationwide French survey including consecutive patients admitted for ST or non-ST-elevation AMI at the end of 2005 in 223 institutions.

Results: Of 3670 patients enrolled, shock occurred in 224 (6.1%), and 3411 survived beyond 30 days or hospital discharge, including 99 (2.9%) with shock. Early survivors with CS had a more severe clinical profile, more frequent concomitant in-hospital complications, and were less often managed invasively than those without CS.

Conclusions: In patients surviving the early phase of AMI, CS at the initial stage carries an increased risk of death up to one year after the acute event. Beyond one year, however, mortality is similar to that of patients without shock.

Trial registration: ClinicalTrials.gov number, NCT00673036, Registered May 5, 2008.

Figures

Figure 1
Figure 1
Five-year survival in patients surviving at 30 days and hospital discharge according to the cardiogenic shock status. HR, hazard ratio.
Figure 2
Figure 2
Landmark analysis: 1-year survival in propensity-score-matched cohorts of early survivors.
Figure 3
Figure 3
Landmark analysis: from one year to five years. Five-year survival in propensity-score-matched cohorts of patients surviving at one year. HR, hazard ratio.

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Source: PubMed

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