Title:
|
Short- and Long-Term Mortality Trends in STEMI-Cardiogenic Shock over Three Decades (1989-2018): the Ruti-STEMI-Shock Registry
|
Author:
|
Garcia Garcia, Cosme; Oliveras, Teresa; El Ouaddi, Nabil; Rueda, Ferran; Serra Flores, Jordi; Labata, Carlos; Ferrer, Marc; Cediel, Germán; Montero, Santiago; Martínez, Maria Jose; Resta, Helena; De Diego, Oriol; Vila, Joan; Degano, Irene R.; Elosua, Roberto; Lupón, Josep; Bayés-Genís, Antoni; Universitat Autònoma de Barcelona. Departament de Medicina
|
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. |
Subject(s):
|
-ST-elevation myocardial infarction -Prognosis -STEMI complications -STEMI mortality |
Rights:
|
open access
Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
https://creativecommons.org/licenses/by/4.0/ |
Document type:
|
Article |
Published by:
|
|
Share:
|
|
Uri:
|
https://ddd.uab.cat/record/233225
|