In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled. For optimal viewing of this site, please ensure that Javascript is enabled for your browser.

The free consultation period for this content is over.

It is now only available year-round to ESC Professional Members, Fellows of the ESC, and Young combined Members

Incidence, management, and in-hospital mortality of cardiogenic shock complicating ST-elevated myocardial infarction in China: insights from the China Acute Myocardial Infarction Registry

Session Poster Session 5

Speaker Yu Ning

Event : ESC Congress 2019

  • Topic : coronary artery disease, acute coronary syndromes, acute cardiac care
  • Sub-topic : Acute Cardiac Care – Cardiogenic Shock
  • Session type : Poster Session

Authors : Y Ning (Beijing,CN), GH Chen (Beijing,CN), JG Yang (Beijing,CN), YJ Yang (Beijing,CN), CY Tian (Beijing,CN), Y Wang (Beijing,CN), HY Xu (Beijing,CN)

Y. Ning1 , G.H. Chen1 , J.G. Yang1 , Y.J. Yang1 , C.Y. Tian1 , Y. Wang1 , H.Y. Xu1 , 1Fuwai Hospital- Chinese Academy of Medical Sciences and Peking Union Medical College - Beijing - China ,

On behalf: the CAMI Registry Study Group

European Heart Journal ( 2019 ) 40 ( Supplement ), 2831

Background and purpose: Limited data is available on the situation of cardiogenic shock (CS) complicating ST-elevated myocardial infarction (STEMI) in China. This study aims to disclose the incidence, management and in-hospital mortality (IHM) of patients with STEMI complicated by CS (STEMICS) in China and at different levels of hospitals.

Methods: We queried the 2013–2016 China Acute Myocardial Infarction (CAMI) registry databases to identify patients with STEMI and/or CS (developing before or during hospitalization). The overall and different hospital-level incidence of STEMICS and IHM were analyzed.

Results: Of 28230 STEMI patients, 2273 patients (8.05%) had CS. The incidence of STEMICS in provincial, prefectural and county-level hospitals were 5.23%, 8.46% and 13.76% (p<0.001), respectively. Primary PCI (PPCI) was performed on 675 patients (29.7%) with STEMICS. The proportion of STEMICS patients undertaking PPCI in provincial, prefectural and county-level hospitals were 46.53%, 31.48% and 8.00% (p<0.001). The overall IHM rate of patients with STEMICS was 49.8% with no difference among the different hospital levels. However, the IHM rate of prehospital STEMICS in county-level hospitals were significantly higher than that in prefectural and provincial hospitals (42.3% versus 33.3% and 28.3%, respectively; p<0.01), while that of in-hospital STEMICS were similar among the different hospital levels (66.5%, 66.9% and 62.2%; provincial, prefectural and county-level hospitals, respectively). After adjustment, the difference of IHM in prehospital STEMICS between county-level hospitals and the other two levels no longer existed. However, once PPCI was excluded from the multivariable adjustment model, the IHM of prehospital STEMICS remained higher in county-level hospitals.

Conclusion: The overall incidence and IHM rate of STEMICS in China are still high. Especially, higher IHM rate of prehospital STEMICS is observed in county-level hospitals, which may be attributed to the lower implementation rate of PPCI.

Table 1. Differences in IHM of prehospital STEMICS between county-level hospitals and other two levels of hospitals before or after adjustment
Provincial hospitals/ County-level hospitalsPrefectural hospitals/ County-level hospitals
Unadjusted OR (95% CI)0.54 (0.36, 0.80); P=0.00190.68 (0.49, 0.94); P=0.0193
Adjusted OR* (95% CI)0.63 (0.34, 1.17); P=0.14550.64 (0.38, 1.08); P=0.0962
Adjusted OR (95% CI)0.49 (0.27, 0.90); P=0.02140.54 (0.32, 0.91); P=0.0198
IHM: in-hospital mortality; OR: odd ratio; CI: confidence interval. *Adjusted for baseline characteristics, in-hospital medications and primary PCI; adjusted for baseline characteristics and in-hospital medications.
Figure 1. Flowchart

Get your access to resources

Join now
  • 1ESC Professional Members – access all ESC Congress resources 
  • 2ESC Association Members (Ivory, Silver, Gold) – access your Association’s resources
  • 3Under 40 or in training - with a Combined Membership, access all resources
Join now

Our sponsors

ESC 365 is supported by Bayer, Boehringer Ingelheim and Lilly Alliance, Bristol-Myers Squibb and Pfizer Alliance, Novartis Pharma AG and Vifor Pharma in the form of educational grants. The sponsors were not involved in the development of this platform and had no influence on its content.

logo esc

Our mission: To reduce the burden of cardiovascular disease

Who we are