title: Temporal Trends and Outcomes of Patients Undergoing Percutaneous Coronary Interventions for Cardiogenic Shock in the Setting of Acute Myocardial Infarction: A Report From the CathPCI Registry.
abstract: OBJECTIVE
  The purpose of this study was to examine the temporal trends in demographics, clinical characteristics, management strategies, and in-hospital outcomes in patients with acute myocardial infarction complicated by cardiogenic shock (CS-AMI) who underwent percutaneous coronary intervention (PCI) from the Cath-PCI Registry (2005 to 2013).
  
  
  BACKGROUND
  The authors examined contemporary use and outcomes of PCI in patients with CS-AMI.
  
  
  METHODS
  The authors used the Cath-PCI Registry to evaluate 56,497 patients (January 2005 to December 2013) undergoing PCI for CS-AMI. Temporal trends in clinical variables and outcomes were assessed.
  
  
  RESULTS
  Compared with cases performed from 2005 to 2006, CS-AMI patients receiving PCI from 2011 to 2013 were more likely to have diabetes, hypertension, dyslipidemia, previous PCI, dialysis, but less likely to have chronic lung disease, peripheral vascular disease, or heart failure within 2 weeks (p < 0.01). Between 2005 and 2006 to 2011 and 2013, intra-aortic balloon pump use decreased (49.5% to 44.9%; p < 0.01), drug-eluting stent use declined (65% to 46%; p < 0.01), and the use of bivalirudin increased (12.6% to 45.6%). Adjusted in-hospital mortality; increased (27.6% in 2005 to 2006 vs. 30.6% in 2011 to 2013, adjusted odds ratio: 1.09, 95% confidence interval: 1.005 to .173; p = 0.04) for patients who were managed with an early invasive strategy (<24 h from symptoms).
  
  
  CONCLUSIONS
  Our study shows that despite the evolution of medical technology and use of contemporary therapeutic measures, in-hospital mortality in CS-AMI patients who are managed invasively continues to rise. Additional research and targeted efforts are indicated to improve outcomes in this high-risk cohort.
authors.affiliation: Cleveland Clinic, Cleveland, Ohio. Electronic address: wayangs@ccf.org.
authors.forename: Siddharth A
authors.initials: SA
authors.lastname: Wayangankar
authors.affiliation: New York University School of Medicine, New York, New York.
authors.forename: Sripal
authors.initials: S
authors.lastname: Bangalore
authors.affiliation: Duke Clinical Research Institute, Durham, North Carolina.
authors.forename: Lisa A
authors.initials: LA
authors.lastname: McCoy
authors.affiliation: Baylor College of Medicine, Houston, Texas.
authors.forename: Hani
authors.initials: H
authors.lastname: Jneid
authors.affiliation: Health Sciences Center and Veterans Affairs Medical Center, University of Oklahoma, Oklahoma City, Oklahoma.
authors.forename: Faisal
authors.initials: F
authors.lastname: Latif
authors.affiliation: UnityPoint Clinic Cardiology, Cedar Rapid, Iowa.
authors.forename: Wassef
authors.initials: W
authors.lastname: Karrowni
authors.affiliation: Weill Cornell Medical College/New York Presbyterian Hospital, New York, New York.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Charitakis
authors.affiliation: Weill Cornell Medical College/New York Presbyterian Hospital, New York, New York.
authors.forename: Dmitriy N
authors.initials: DN
authors.lastname: Feldman
authors.affiliation: American University of Beirut, Beirut, Lebanon.
authors.forename: Habib A
authors.initials: HA
authors.lastname: Dakik
authors.affiliation: Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Laura
authors.initials: L
authors.lastname: Mauri
authors.affiliation: Duke Clinical Research Institute, Durham, North Carolina.
authors.forename: Eric D
authors.initials: ED
authors.lastname: Peterson
authors.affiliation: School of Medicine, University of Colorado, Denver, Colorado.
authors.forename: John
authors.initials: J
authors.lastname: Messenger
authors.affiliation: Duke Clinical Research Institute, Durham, North Carolina.
authors.forename: Mathew
authors.initials: M
authors.lastname: Roe
authors.affiliation: Health Sciences Center, Texas Tech University, El Paso, Texas.
authors.forename: Debabrata
authors.initials: D
authors.lastname: Mukherjee
authors.affiliation: St. Louis VA Medical Center, and Department of Internal Medicine, School of Medicine, Saint Louis University, Saint Louis, Missouri.
authors.forename: Andrew
authors.initials: A
authors.lastname: Klein
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D015897:Comorbidity; D054855:Drug-Eluting Stents / Q000639:trends; D005260:Female; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D016017:Odds Ratio; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality / Q000639:trends*; D010818:Practice Patterns, Physicians' / Q000639:trends*; D017064:Process Assessment, Health Care / Q000639:trends*; D012042:Registries; D012307:Risk Factors; D012770:Shock, Cardiogenic / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States
keywords: acute coronary syndrome(s); acute myocardial infarction; cardiogenic shock; percutaneous coronary intervention