Abstract | OBJECTIVES: This study sought to assess long-term outcome and determine its predictors among 30-day survivors of cardiogenic shock. BACKGROUND: Patients with cardiogenic shock have high in-hospital and 30-day mortality, but there are little data about those who survive beyond 30 days. METHODS: RESULTS: Of 22,883 patients enrolled in the U.S., shock occurred in 1,891 (8.3%); 953 (50.4%) survived 30 days and 527 (27.8%) survived 11 years. Of 20,992 U.S. patients without shock, 20,360 (96.9%) survived 30 days and 14,131 (67.3%) survived 11 years. After the first year, 2% to 4% of patients died each year regardless of whether they had cardiogenic shock. Using Cox proportional hazards models, we were able to predict long-term mortality in all U.S. GUSTO-I 30-day survivors from their baseline demographics and in-hospital complications. The strongest predictors were diabetes mellitus, cardiogenic shock, hypertension, previous myocardial infarction, current smoking, anterior infarct, higher Killip class, higher heart rate, and older age; patients >75 years were at highest risk. Percutaneous revascularization during the index hospitalization was associated with a reduced risk of death. CONCLUSIONS: Among patients with cardiogenic shock who survive 30 days after STEMI, annual mortality rates of 2% to 4% approximate those of patients without shock.
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Authors | Mandeep Singh, Jennifer White, David Hasdai, Patricia K Hodgson, Peter B Berger, Eric J Topol, Robert M Califf, David R Holmes Jr |
Journal | Journal of the American College of Cardiology
(J Am Coll Cardiol)
Vol. 50
Issue 18
Pg. 1752-8
(Oct 30 2007)
ISSN: 1558-3597 [Electronic] United States |
PMID | 17964038
(Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
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Topics |
- Aged
- Female
- Fibrinolytic Agents
(therapeutic use)
- Follow-Up Studies
- Hospital Mortality
- Humans
- Male
- Middle Aged
- Myocardial Infarction
(complications, drug therapy, mortality)
- Proportional Hazards Models
- Risk Factors
- Shock, Cardiogenic
(etiology, mortality)
- Survival Rate
- Time Factors
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