UMass, U of U researchers observe early risk period for survivors of cardiogenic shock for heart attack patients

February 16, 2016

A pair of studies suggest heart attack patients are more likely to die or return to the hospital in the first 60 days after discharge if they had cardiogenic shock but the difference fades thereafter. In the first study, researchers from University of Utah in Salt Lake City found 33.9% of cardiogenic shock patients had been rehospitalized or died at 60 days compared with 24.9% of myocardial infarction (MI) patients who didn't go into shock. At one year, rates were similar for the shock and nonshock groups (59.1% vs. 52.3%). In an accompanying editorial, colleagues suggested that given few hospitalizations (less than one-quarter) attributed to heart failure, patient comorbidities are increasingly important. In a second population-based study, researchers at UMass Medical School found in-hospital mortality with cardiogenic shock has been declining. On average 3.7% of acute MI patients developed cardiogenic shock during their hospitalization over the study period, without any significant trends up or down in crude or multivariable-adjusted analyses. The study found the in-hospital case-fatality rate declined from 47.1% in 2001/2003 down to 28.6% in 2009/2011, with the researchers noting increases in the use of evidence-based cardiac medications and interventional procedures "paralleled the increasing hospital survival trends." The authors concluded that despite declines in the death rates associated with cardiogenic shock in patients hospitalized with AMI, cardiogenic shock continues to be a serious complication of AMI.