Document Detail

Temporal trends in cardiogenic shock complicating acute myocardial infarction.
MedLine Citation:
PMID:  10202167     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Limited information is available on trends in the incidence of and mortality due to cardiogenic shock complicating acute myocardial infarction. We studied the incidence of cardiogenic shock complicating acute myocardial infarction and in-hospital death rates among patients with this condition in a single community from 1975 through 1997. METHODS: We conducted an observational study of 9076 residents of metropolitan Worcester, Massachusetts, who were hospitalized with confirmed acute myocardial infarction in all local hospitals during 11 one-year periods between 1975 and 1997. Our study included periods before and after the advent of reperfusion therapy. RESULTS: The incidence of cardiogenic shock remained relatively stable over time, averaging 7.1 percent among patients with acute myocardial infarction. The results of a multivariable regression analysis indicated that the patients hospitalized during recent study years were not at a substantially lower risk for shock than patients hospitalized in the mid-to-late 1970s. Patients in whom cardiogenic shock developed had a significantly greater risk of dying during hospitalization (71.7 percent) than those who did not have cardiogenic shock (12.0 percent, P<0.001). A significant trend toward an increase in in-hospital survival among patients with cardiogenic shock in the mid-to-late 1990s was found in crude and adjusted analyses. CONCLUSIONS: Our findings indicate no significant change in the incidence of cardiogenic shock complicating acute myocardial infarction over a 23-year period. However, the short-term survival rate has increased in recent years at the same time as the use of coronary reperfusion strategies has increased.
R J Goldberg; N A Samad; J Yarzebski; J Gurwitz; C Bigelow; J M Gore
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The New England journal of medicine     Volume:  340     ISSN:  0028-4793     ISO Abbreviation:  N. Engl. J. Med.     Publication Date:  1999 Apr 
Date Detail:
Created Date:  1999-04-15     Completed Date:  1999-04-15     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0255562     Medline TA:  N Engl J Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1162-8     Citation Subset:  AIM; IM    
Department of Medicine, University of Massachusetts Medical School, Worcester 01655, USA.
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MeSH Terms
Hospital Mortality / trends*
Hospitals, Community
Hospitals, Teaching
Logistic Models
Massachusetts / epidemiology
Middle Aged
Myocardial Infarction / complications*,  mortality,  therapy
Myocardial Reperfusion / statistics & numerical data,  trends
Risk Factors
Shock, Cardiogenic / epidemiology*,  etiology,  mortality,  therapy
Survival Rate / trends
Grant Support

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