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Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.  Labels: BACKGROUND, OBJECTIVE, METHODS, RESULTS. Meshes: Aged, Female, Hospital Mortality, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Multivariate Analysis, Netherlands, Percutaneous Coronary Intervention, Proportional Hazards Models, Prospective Studies, Risk Assessment, Risk Factors, ST Elevation Myocardial Infarction, Shock, Cardiogenic, Survivors, Time Factors, Treatment Outcome.
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Does cardiogenic Shock predict Long-term Mortality in Hospital Survivors of STEMI Treated With Primary Percutaneous Coronary Intervention? Context: ST-segment elevation myocardial infarction (STEMI) complicated by cardiogenic shock (CS) has a poor prognosis. Recently published data suggested, however, that CS does not affect long-term mortality in hospital survivors of STEMI. We investigated whether this could be confirmed in a larger cohort. STEMI complicated by CS leads to worse long-term survival. A prospective cohort study was performed in 7412 consecutive patients with STEMI treated by primary percutaneous coronary intervention (angioplasty). The predictive value of CS on long-term mortality was assessed in hospital survivors. Multivariate analysis, adjusting for differences in baseline variables, was performed to assess the independent prognostic value of CS. Cardiogenic shock was observed in 387 patients (5.2%). The total in-hospital mortality was 254 (3.4%), and mortality was significantly higher in patients with CS (20.0% vs 2.6%; P < 0.001). The 1-year mortality in hospital survivors was 10.3% in patients with CS and 3.9% in patients without CS (P < 0.001). After multivariate analysis, CS was still a significant predictor of long-term mortality in hospital survivors (hazard ratio: 2.6, 95% confidence interval: 1.64-4.01).
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Cardiogenic shock remains a strong predictor of long-term mortality in hospital survivors of STEMI treated by primary percutaneous coronary intervention. Final Decision: yes