Objectives: to define the risk factors, epidemiological data and outcomes of patients admitted due to AMI who presented cardiogenic shock at admission or during admission to a tertiary hospital.
Methods: a longitudinal, observational study of consecutive patients admitted with acute coronary syndrome (ACS) from June 1, 2015 to October 31, 2017. Data were obtained from the medical records, as well as interviews of patients during hospitalization. We compared the demographic, clinical and outcomes data of patients with cardiogenic shock (wCC) and without cardiogenic shock (woCC) in this population.
Results: there were 216 patients analyzed and the incidence of cardiogenic shock was 9.7% and was manifested at admission in 33.3% of the cases. The characteristics in the wCC group and woCC were, respectively: mean age of 76.1±10.56 x 70.8±11.39 years (p=0.04), male (66.7% x 70.3%, p=0.75), smoking (28.6% x 52.3%, p=0.03), dyslipidemia (57.1% x 55.9%, p = 0.91), systemic arterial hypertension (66.7% x 77.9%, p=0.24) and diabetes mellitus (42.9% x 33.3%, p=0.38); ST elevation AMI (47.6% x 28.7%, p=0.07) and non-ST elevation AMI (52.4% x 71.3%, p=0.07). Other complications were renal dysfunction (14.3% x 7.7%, p=0.29), atrial fibrillation (19% x 7.2%, p=0.06), pericardial effusion (95.2% x 32.8%, p<0.001), cardiorespiratory arrest during hospitalization (42.9% x 1%, p<0.001), use of mechanical circulatory support device (57.1% x 1%, p <0.001). In the wCC group: intra-aortic balloon (58.3%), Centrimag (9.5%), extracorporeal membrane circulation (14.2%); and in woCC group: intra-aortic balloon (1%). Overall mortality were 61% in wCC group and 1% in woCC group (p<0.001).
Conclusion: cardiogenic shock occurred in older patients, that presented with more renal dysfunction, atrial fibrillation, pericardial effusion and cardiorespiratory arrest. Despite the technological advances in the treatment of AMI, the circulatory support devices did not reduce the morbidity and mortality of this entity, remaining extremely high.