Long-Term Outcomes of Acute Myocardial Infarction With Concomitant Cardiogenic Shock and Cardiac Arrest
Section snippets
Methods
This study used de-identified administrative claims data from the OptumLabs Data Warehouse, which includes medical and pharmacy claims and enrollment records for commercial and Medicare Advantage enrollees. The database contains longitudinal health information on enrollees and patients, representing a diverse mixture of ages, ethnicities and geographical regions across the United States.15, 16, 17 The data, analytic methods, and study materials will not be made available to other researchers
Results
During this 8.5-year period, there were 163,071 patients admitted with a primary diagnosis of AMI, of which CA and CS were present in 12,186 (7.5%) and 10,524 (6.5%) respectively. Both CA and CS were present in 3,965 (2.4%) patients. All cohorts were predominantly of male sex and white race (Table 1). Coronary angiography was used less frequently in CA + CS (62.2%) and CA only (60.2%) cohorts compared with the others 2 cohorts (68%). The CA + CS cohort had higher rates of noncardiac organ
Discussion
In the largest reported study evaluating the long-term outcomes of CA and CS complicating AMI, we noted several important findings: (1) 2.4% of all AMI patients had concomitant CA + CS, which was associated with an higher in-hospital mortality compared with CA or CS alone; (2) among patients that survive to hospital discharge, CS during the index admission, with or without concomitant CA, is associated with higher long-term mortality and MACCE, while CA alone is only associated with higher
Disclosures
All authors have reported that they have no relationships relevant to the contents of this paper to disclose.
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Funding: This analysis was funded by the Mayo Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery. This manuscript was written in partial fulfillment of requirements for the post-doctoral master's program (Dr. Vallabhajosyula). This program is funded by Clinical and Translational Science Award Grant Number UL1 TR000135 from the National Center for Advancing Translational Sciences, a component of the National Institutes of Health. Its contents are solely the responsibility of the authors and do not necessarily represent the official view of National Institutes of Health.