Cardiogenic shock epidemiology and demographics
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]
Overview
In defiance of the historic numbers of mortality from cardiogenic shock of 80% to 90%, in the modern era, this type of shock comprises a mortality risk of around 50%, in the face of the diagnostic and treatment techniques, which have greatly been developed in recent years. Depending on the demographic and clinical factors, this risk can range from 10% to 80%. The incidence of cardiogenic shock among patients with acute MI is approximately 5% to 10%.[1][2] Because atherosclerosis and myocardial infarction are both more frequent among males, cardiogenic shock is more common in this gender. However, because women tend to present with acute myocardial infarction at a later age, along with the fact that they have a greater chance of having multivessel coronary artery disease when they first develop symptoms, a greater proportion of women with acute MI develop cardiogenic shock.[3]
Epidemiology and Demographics
With the improvement in the time for diagnosis and therapeutic measures offered for acute myocardial infarction, in which increasing rates of use of primary PCI in recent years have a major role, the once very stable incidence of cardiogenic shock in this group of patients is finally declining.[4] Yet, cardiogenic shock is still an important complication in 5-8% of patients presenting with ST elevation myocardial infarction[5][6] and 2.5% of those with non ST elevation myocardial infarction.[7] This represents around 40000 to 50000 patients every year in the United States.[8] Despite these numbers and the high incidence of left ventricular dysfunction following myocardial infarction, cardiogenic shock due to right ventricle failure (incidence of 2.8%) has as high mortality risk as shock following left ventricle failure.[9] According to the SHOCK registry, both groups of patients benefit equally from revascularization procedures.[10]
Cardiogenic shock has shown to have greater incidence and mortality rate in certain classes of patients:
- Elderly[11][12][13]
- Diabetic patients[14]
- Female sex, although initially classified as an independent predictor of outcome,[15] studies revealed that this assumption wasn't true.[12][16][17]
- MI with larger extent of left ventricular injury
References
- ↑ Goldberg RJ, Samad NA, Yarzebski J, et al. Temporal trends in cardiogenic shock complicating acute myocardial infarction. N Engl J Med. Apr 15 1999;340(15):1162-8.
- ↑ Hasdai D, Holmes DR, Topol EJ, et al. Frequency and clinical outcome of cardiogenic shock during acute myocardial infarction among patients receiving reteplase or alteplase. Results from GUSTO-III. Global Use of Strategies to Open Occluded Coronary Arteries. Eur Heart J. Jan 1999;20(2):128-35.
- ↑ Hasdai D, Califf RM, Thompson TD, et al. Predictors of cardiogenic shock after thrombolytic therapy for acute myocardial infarction. J Am Coll Cardiol. Jan 2000;35(1):136-43.
- ↑ Hasdai, David. (2002). Cardiogenic shock : diagnosis and treatmen. Totowa, N.J.: Humana Press. ISBN 1-58829-025-5.
- ↑ Fox KA, Anderson FA, Dabbous OH, Steg PG, López-Sendón J, Van de Werf F; et al. (2007). "Intervention in acute coronary syndromes: do patients undergo intervention on the basis of their risk characteristics? The Global Registry of Acute Coronary Events (GRACE)". Heart. 93 (2): 177–82. doi:10.1136/hrt.2005.084830. PMC 1861403. PMID 16757543.
- ↑ Babaev A, Frederick PD, Pasta DJ, Every N, Sichrovsky T, Hochman JS; et al. (2005). "Trends in management and outcomes of patients with acute myocardial infarction complicated by cardiogenic shock". JAMA. 294 (4): 448–54. doi:10.1001/jama.294.4.448. PMID 16046651.
- ↑ Hasdai D, Harrington RA, Hochman JS, Califf RM, Battler A, Box JW; et al. (2000). "Platelet glycoprotein IIb/IIIa blockade and outcome of cardiogenic shock complicating acute coronary syndromes without persistent ST-segment elevation". J Am Coll Cardiol. 36 (3): 685–92. PMID 10987585.
- ↑ Thom T, Haase N, Rosamond W, Howard VJ, Rumsfeld J, Manolio T; et al. (2006). "Heart disease and stroke statistics--2006 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee". Circulation. 113 (6): e85–151. doi:10.1161/CIRCULATIONAHA.105.171600. PMID 16407573.
- ↑ Jacobs AK, Leopold JA, Bates E, Mendes LA, Sleeper LA, White H; et al. (2003). "Cardiogenic shock caused by right ventricular infarction: a report from the SHOCK registry". J Am Coll Cardiol. 41 (8): 1273–9. PMID 12706920.
- ↑ Hochman, Judith S; Buller, Christopher E; Sleeper, Lynn A; Boland, Jean; Dzavik, Vladimir; Sanborn, Timothy A; Godfrey, Emilie; White, Harvey D; Lim, John; LeJemtel, Thierry (2000). "Cardiogenic shock complicating acute myocardial infarction—etiologies, management and outcome: a report from the SHOCK Trial Registry". Journal of the American College of Cardiology. 36 (3): 1063–1070. doi:10.1016/S0735-1097(00)00879-2. ISSN 0735-1097.
- ↑ Hasdai D, Holmes DR, Califf RM, Thompson TD, Hochman JS, Pfisterer M; et al. (1999). "Cardiogenic shock complicating acute myocardial infarction: predictors of death. GUSTO Investigators. Global Utilization of Streptokinase and Tissue-Plasminogen Activator for Occluded Coronary Arteries". Am Heart J. 138 (1 Pt 1): 21–31. PMID 10385759.
- ↑ 12.0 12.1 Zeymer U, Vogt A, Zahn R, Weber MA, Tebbe U, Gottwik M; et al. (2004). "Predictors of in-hospital mortality in 1333 patients with acute myocardial infarction complicated by cardiogenic shock treated with primary percutaneous coronary intervention (PCI); Results of the primary PCI registry of the Arbeitsgemeinschaft Leitende Kardiologische Krankenhausärzte (ALKK)". Eur Heart J. 25 (4): 322–8. doi:10.1016/j.ehj.2003.12.008. PMID 14984921.
- ↑ Hochman JS, Sleeper LA, Webb JG, Sanborn TA, White HD, Talley JD; et al. (1999). "Early revascularization in acute myocardial infarction complicated by cardiogenic shock. SHOCK Investigators. Should We Emergently Revascularize Occluded Coronaries for Cardiogenic Shock". N Engl J Med. 341 (9): 625–34. doi:10.1056/NEJM199908263410901. PMID 10460813.
- ↑ Shindler DM, Palmeri ST, Antonelli TA, Sleeper LA, Boland J, Cocke TP; et al. (2000). "Diabetes mellitus in cardiogenic shock complicating acute myocardial infarction: a report from the SHOCK Trial Registry. SHould we emergently revascularize Occluded Coronaries for cardiogenic shocK?". J Am Coll Cardiol. 36 (3 Suppl A): 1097–103. PMID 10985711.
- ↑ Klein LW, Shaw RE, Krone RJ, Brindis RG, Anderson HV, Block PC; et al. (2005). "Mortality after emergent percutaneous coronary intervention in cardiogenic shock secondary to acute myocardial infarction and usefulness of a mortality prediction model". Am J Cardiol. 96 (1): 35–41. doi:10.1016/j.amjcard.2005.02.040. PMID 15979429.
- ↑ Wong SC, Sleeper LA, Monrad ES, Menegus MA, Palazzo A, Dzavik V; et al. (2001). "Absence of gender differences in clinical outcomes in patients with cardiogenic shock complicating acute myocardial infarction. A report from the SHOCK Trial Registry". J Am Coll Cardiol. 38 (5): 1395–401. PMID 11691514.
- ↑ Antoniucci D, Migliorini A, Moschi G, Valenti R, Trapani M, Parodi G; et al. (2003). "Does gender affect the clinical outcome of patients with acute myocardial infarction complicated by cardiogenic shock who undergo percutaneous coronary intervention?". Catheter Cardiovasc Interv. 59 (4): 423–8. doi:10.1002/ccd.10573. PMID 12891599.