In:
European Journal of Heart Failure, Wiley, Vol. 17, No. 11 ( 2015-11), p. 1124-1132
Abstract:
Despite advances in the management of patients with acute coronary syndrome ( ACS ), cardiogenic shock ( CS ) remains the leading cause of death in these patients. We describe the evolution of clinical characteristics, in‐hospital management, and outcome of patients with CS complicating ACS . Methods and results We analysed data from five Italian nationwide prospective registries, conducted between 2001 and 2014, including consecutive patients with ACS . Out of 28 217 ACS patients enrolled, 1209 (4.3%) had CS : 526 (44%) at the time of admission and 683 (56%) later on during hospitalization. Over the years, a reduction in the incidence of CS was observed, even though this was not statistically significant ( P for trend = 0.17). The proportions of CS patients with a history of heart failure declined, whereas the proportion of those with hypertension, renal dysfunction, previous PCI , and AF significantly increased. The use of PCI considerably increased from 2001 to 2014 [19% to 60%; percentage change 41, 95% confidence interval ( CI ) 29–51]. In‐hospital mortality of CS patients decreased from 68% (95% CI 59–76) in 2001 to 38% (95% CI 29–47) in 2014 (percentage change −30, 95% CI −41 to −18). Compared with 2001, the risk of death was significantly lower in all of the registries, with reductions in adjusted mortality between 45% and 66%. Conclusions Over the last 14 years, substantial changes occurred in the clinical characteristics and management of patients with CS complicating ACS , with a greater use of PCI and a significant reduction in adjusted mortality rate.
Type of Medium:
Online Resource
ISSN:
1388-9842
,
1879-0844
DOI:
10.1002/ejhf.2015.17.issue-11
Language:
English
Publisher:
Wiley
Publication Date:
2015
detail.hit.zdb_id:
1500332-2
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