Thirty-Year Trends (1975 to 2005) in the Magnitude of, Management of, and Hospital Death Rates Associated With Cardiogenic Shock in Patients With Acute Myocardial Infarction : A Population-Based Perspective

Limited information is available about potentially changing and contemporary trends in the incidence and hospital death rates of cardiogenic shock complicating acute myocardial infarction. The objectives of our study were to examine 3-decade-long trends (1975 to 2005) in the incidence rates of cardi...

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Bibliographic Details
Published in:Circulation (New York, N.Y.) N.Y.), 2009-03, Vol.119 (9), p.1211-1219
Main Authors: GOLDBERG, Robert J, SPENCER, Frederick A, GORE, Joel M, LESSARD, Darleen, YARZEBSKI, Jorge
Format: Article
Language:English
Subjects:
Aged
Biological and medical sciences
Blood and lymphatic vessels
Cardiology. Vascular system
Coronary heart disease
Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous
Female
Heart
Hospital Mortality - trends
Hospitals, Community - statistics & numerical data
Hospitals, Teaching - statistics & numerical data
Hospitals, Urban - statistics & numerical data
Humans
Incidence
Male
Massachusetts - epidemiology
Medical sciences
Myocardial Infarction - mortality
Myocardial Infarction - therapy
Prognosis
Risk Factors
Shock, Cardiogenic - mortality
Shock, Cardiogenic - therapy
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Summary:Limited information is available about potentially changing and contemporary trends in the incidence and hospital death rates of cardiogenic shock complicating acute myocardial infarction. The objectives of our study were to examine 3-decade-long trends (1975 to 2005) in the incidence rates of cardiogenic shock complicating acute myocardial infarction, patient characteristics and treatment practices associated with this clinical complication, and hospital death rates in residents of a large central New England community hospitalized with acute myocardial infarction at all area medical centers. The study population consisted of 13 663 residents of the Worcester (Mass) metropolitan area hospitalized with acute myocardial infarction at all greater Worcester medical centers during 15 annual periods between 1975 and 2005. Overall, 6.6% of patients developed cardiogenic shock during their index hospitalization. The incidence rates of cardiogenic shock remained stable between 1975 and the late 1990s but declined in an inconsistent manner thereafter. Patients in whom cardiogenic shock developed had a significantly greater risk of dying during hospitalization (65.4%) than those who did not develop cardiogenic shock (10.6%) (P
ISSN:0009-7322
1524-4539
DOI:10.1161/CIRCULATIONAHA.108.814947