title: Age adjusted nationwide trends in the incidence of all cause and ST elevation myocardial infarction associated cardiogenic shock based on gender and race in the United States.
abstract: BACKGROUND
  Recent improvement in the care of patients with myocardial infarction should lead to better outcome. The goal of this study was to evaluate the incidence of all cause cardiogenic shock (CS) and CS occurring in the setting of ST elevation myocardial infarction (STEMI) in the United States.
  
  
  METHODS
  The Nationwide Inpatient Sample (NIS) database was utilized to calculate the age-adjusted incident rate of CS from 1996 to 2006 based on ICD-9 coding in the setting of STEMI. Furthermore, we evaluated this trend based on race and gender.
  
  
  RESULTS
  A total population of 52,784,917 patients was available between 1996 and 2006. We found that the incidence of all cause CS has not changed over time. However, in the setting of STEMI, CS has been declining slowly over the last 10 years. The age-adjusted rate for CS was 4.3 per 100,000 in 1996 which remained steady with an incidence of 3.1 per 100.000 in 2006 (p<0.01). This decline was persistent across different race or gender. However, African Americans and female gender had persistently lower rate of CS.
  
  
  CONCLUSIONS
  Advancement in the treatment of acute STEMI has led to gradual reduction in the incidence of STEMI related cardiogenic shock irrespective of ethnicities or gender suggesting improving outcome of patients presenting with STEMI in recent years.
authors.affiliation: CareMore Health Care Arizona; Division of Cardiology, The Southern Arizona VA health Care system, Tucson, Arizona; Division of Cardiology, University of Arizona Sarver Heart Center, Tucson, Arizona. Electronic address: rmova@aol.com.
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Movahed
authors.affiliation: Division of Cardiology, The Southern Arizona VA health Care system, Tucson, Arizona.
authors.forename: Muhammad F
authors.initials: MF
authors.lastname: Khan
authors.affiliation: Division of Cardiology, University of Arizona Sarver Heart Center, Tucson, Arizona.
authors.forename: Mehrnoosh
authors.initials: M
authors.lastname: Hashemzadeh
authors.affiliation: Department of Medicine, Long Beach VA Medical Center.
authors.forename: Mehrtash
authors.initials: M
authors.lastname: Hashemzadeh
mesh_terms: D016208:Databases, Factual; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D009203:Myocardial Infarction / Q000175:diagnosis / Q000453:epidemiology* / Q000208:ethnology / Q000628:therapy; D011379:Prognosis; D044469:Racial Groups; D012189:Retrospective Studies; D017678:Sex Distribution; D012737:Sex Factors; D012770:Shock, Cardiogenic / Q000175:diagnosis / Q000453:epidemiology* / Q000208:ethnology / Q000517:prevention & control; D013997:Time Factors; D014481:United States / Q000453:epidemiology
keywords: Acute coronary syndrome; Acute myocardial infarction; Coronary artery disease; Shock