Long-term outcome in early survivors of cardiogenic shock at the acute stage of myocardial infarction: a landmark analysis from the French registry of Acute ST-elevation and non-ST-elevation Myocardial Infarction (FAST-MI) Registry

Nadia Aissaoui (1, 2) , Etienne Puymirat (3, 2, 1) , Tabassome Simon (4, 5, 6) , Eric Bonnefoy-Cudraz (7) , Denis Angoulvant (8) , Francois Schiele (9) , Hakim Benamer (10) , Philippe Quandalle (11) , Fabrice Prunier (12) , Eric Durand (13) , Laurence Berard (4) , Didier Blanchard (14) , Nicolas Danchin (2, 1)

1 UPD5 Médecine - Université Paris Descartes - Faculté de Médecine
2 Dpt Cardiologie [CHU Georges Pompidou]
3 PARCC - UMR-S U970 - Paris-Centre de Recherche Cardiovasculaire
4 CHU Saint-Antoine [AP-HP]
5 LBPC (U698) - Hémostase, bio-ingénierie et remodelage cardiovasculaires
6 UPMC - Université Pierre et Marie Curie - Paris 6
7 Service de pneumologie [Centre Hospitalier Lyon Sud - HCL]
8 CHRU Tours - Centre Hospitalier Régional Universitaire de Tours
9 CHRU Besançon - Centre Hospitalier Régional Universitaire de Besançon
10 Institut Hospitalier J. Cartier
11 Hôpital Victor Provo [Roubaix]
12 CHU Angers - Centre Hospitalier Universitaire d'Angers
13 CHU Rouen
14 Clinique St Gatien et Groupe Athérome Cardiologie Interventionnelle/SF

Introduction: There are little data about patients with cardiogenic shock (CS) who survive the early phase of acute myocardial infarction (AMI). The aim of this study was to assess long-term (5-year) mortality among early survivors of AMI, according to the presence of CS at the acute stage. Methods: We analyzed 5-year follow-up data from the French registry of Acute ST-elevation and non-ST-elevation Myocardial Infarction (FAST-MI) 2005 registry, a nationwide French survey including consecutive patients admitted for ST or non-ST-elevation AMI at the end of 2005 in 223 institutions. Results: Of 3670 patients enrolled, shock occurred in 224 (6.1%), and 3411 survived beyond 30 days or hospital discharge, including 99 (2.9%) with shock. Early survivors with CS had a more severe clinical profile, more frequent concomitant in-hospital complications, and were less often managed invasively than those without CS. Five-year survival was 59% in patients with, versus 76% in those without shock (adjusted hazard ratio (HR) = 1.72 [1.24-2.38], P = 0.001). The excess of death associated with CS, however, was observed only during the first year (one-year survival: 77% vs 93%, adjusted HR: 2.87 [1.85 to 4.46] P <0.001), while survival from one to 5 years was similar (76% vs 82%, adjusted HR: 1.06 [0.64 to 1.74]). Propensity score-matched analyses yielded similar results. Conclusions: In patients surviving the early phase of AMI, CS at the initial stage carries an increased risk of death up to one year after the acute event. Beyond one year, however, mortality is similar to that of patients without shock.

Domains: Human health and pathology

Nadia Aissaoui, Etienne Puymirat, Tabassome Simon, Eric Bonnefoy-Cudraz, Denis Angoulvant, et al.. Long-term outcome in early survivors of cardiogenic shock at the acute stage of myocardial infarction: a landmark analysis from the French registry of Acute ST-elevation and non-ST-elevation Myocardial Infarction (FAST-MI) Registry. Critical Care, 2014, 18 (5), pp.516. ⟨10.1186/s13054-014-0516-y⟩. ⟨hal-01313020⟩