Título original: Post-Hospital Outcomes of Patients With Acute Myocardial Infarction With Cardiogenic Shock Findings From the NCDR. Referencia: Rashmee U. Shah et al. J Am Coll Cardiol. 2016;67(7):739-747.
Even though mortality after cardiogenic shock MI is quite high, many survive and are discharged. So far, there is little we know about their prognosis after discharge.
This study sought to assess patients undergoing acute myocardial infarction included in the ACTION registry (Acute Coronary Treatment and Intervention Outcomes Network Registry–Get with the Guidelines) post discharge. The study used proportional hazard models to test the association between cardiogenic shock and events after discharge.
Out of 112668 AMI survivors discharged, 5% presented cardiogenic shock.
Death rate was significantly higher in those presenting cardiogenic shock both at 60 days (9.6% vs. 5.5%) and one year (22.4% vs. 16.7%).
After adjusting baseline characteristics, death risk continued to be higher in those presenting cardiogenic shock within 60 days (HR: 1.62; CI 95% 1.46 to 1.80) but resulted similar after this period (HR: 1.08 between day 61 and 365; CI 95% 1.00 to 1.18).
All cause rehospitalization or death rates also resulted higher in cardiogenic shock patients at 60 days (HR: 1.28; 95% CI: 1.21 to 1.35) and after this period the risk matched non cardiogenic shock patients (HR: 0.95 between day 61 and 365; CI 95% 0.89 to 1.01).
Conclusion
For cardiogenic shock survivors, death and or rehospitalization rates are time dependent and concentrates in the first 60 days after discharge. After this period, prognosis resulted similar to that of patients with no cardiogenic shock.