Temporal trends in incidence and patient characteristics in cardiogenic shock following acute myocardial infarction from 2010 to 2017: a Danish cohort study

Ole K L Helgestad*, Jakob Josiassen, Christian Hassager, Lisette O Jensen, Lene Holmvang, Anne Sørensen, Martin Frydland, Annmarie T Lassen, Nanna L J Udesen, Henrik Schmidt, Hanne B Ravn, Jacob E Møller

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

Aim: We sought to describe the contemporary annual incidence of cardiogenic shock (CS) following acute myocardial infarction (AMICS), the proportion of patients developing CS following ST-elevation myocardial infarction (STEMI), and other temporal changes in AMICS in Denmark between 2010 and 2017. Methods and results: Medical records of patients suspected of having AMICS during 2010–2017 were reviewed to identify consecutive patients with AMICS in a cohort corresponding to two-thirds of the Danish population. Due to changes in recruitment area over the study period, population-based incidence could only be calculated from 2012 to 2017. A total of 1716 patients with AMICS were identified and an increase in the annual incidence was observed, from a nadir 65.3 per million person-years in 2013 to 80.0 per million person-years in 2017 (P-value for trend < 0.001). This trend corresponded to an increase in patients with non-STEMI and a decrease in patients developing CS after STEMI (10.0–6.6%, P-value for trend < 0.001) Also, mean arterial blood pressure at the time of AMICS was lower (63 ± 11 mmHg to 61 ± 13 mmHg, P-value for trend = 0.001) and the frequency of patients with left ventricular ejection fraction ≤ 30% increased (61.8%–71.4%, P-value for trend = 0.004). The annual 30-day mortality during the study period remained unchanged at about 50%. Conclusion: The incidence rate of AMICS increased in the Danish population between 2012 and 2017. Fewer patients with STEMI developed CS, and haemodynamic severity of CS increased during the study period; however, survival rates remained unchanged.

Original languageEnglish
JournalEuropean Journal of Heart Failure
Volume21
Issue number11
Pages (from-to)1370-1378
ISSN1388-9842
DOIs
Publication statusPublished - Nov 2019

Fingerprint

Cardiogenic Shock
Cohort Studies
Incidence
Arterial Pressure
Population
Denmark
Medical Records
Survival Rate

Keywords

  • Cardiogenic shock
  • Epidemiology
  • Mechanical circulatory support
  • Myocardial infarction
  • Percutaneous coronary intervention

Cite this

@article{7e701fcc1b424e408f4b1da24e93276c,
title = "Temporal trends in incidence and patient characteristics in cardiogenic shock following acute myocardial infarction from 2010 to 2017: a Danish cohort study",
abstract = "Aim: We sought to describe the contemporary annual incidence of cardiogenic shock (CS) following acute myocardial infarction (AMICS), the proportion of patients developing CS following ST-elevation myocardial infarction (STEMI), and other temporal changes in AMICS in Denmark between 2010 and 2017. Methods and results: Medical records of patients suspected of having AMICS during 2010–2017 were reviewed to identify consecutive patients with AMICS in a cohort corresponding to two-thirds of the Danish population. Due to changes in recruitment area over the study period, population-based incidence could only be calculated from 2012 to 2017. A total of 1716 patients with AMICS were identified and an increase in the annual incidence was observed, from a nadir 65.3 per million person-years in 2013 to 80.0 per million person-years in 2017 (P-value for trend < 0.001). This trend corresponded to an increase in patients with non-STEMI and a decrease in patients developing CS after STEMI (10.0–6.6{\%}, P-value for trend < 0.001) Also, mean arterial blood pressure at the time of AMICS was lower (63 ± 11 mmHg to 61 ± 13 mmHg, P-value for trend = 0.001) and the frequency of patients with left ventricular ejection fraction ≤ 30{\%} increased (61.8{\%}–71.4{\%}, P-value for trend = 0.004). The annual 30-day mortality during the study period remained unchanged at about 50{\%}. Conclusion: The incidence rate of AMICS increased in the Danish population between 2012 and 2017. Fewer patients with STEMI developed CS, and haemodynamic severity of CS increased during the study period; however, survival rates remained unchanged.",
keywords = "Cardiogenic shock, Epidemiology, Mechanical circulatory support, Myocardial infarction, Percutaneous coronary intervention",
author = "Helgestad, {Ole K L} and Jakob Josiassen and Christian Hassager and Jensen, {Lisette O} and Lene Holmvang and Anne S{\o}rensen and Martin Frydland and Lassen, {Annmarie T} and Udesen, {Nanna L J} and Henrik Schmidt and Ravn, {Hanne B} and M{\o}ller, {Jacob E}",
note = "{\circledC} 2019 The Authors. European Journal of Heart Failure {\circledC} 2019 European Society of Cardiology.",
year = "2019",
month = "11",
doi = "10.1002/ejhf.1566",
language = "English",
volume = "21",
pages = "1370--1378",
journal = "European Journal of Heart Failure",
issn = "1388-9842",
publisher = "JohnWiley & Sons Ltd.",
number = "11",

}

Temporal trends in incidence and patient characteristics in cardiogenic shock following acute myocardial infarction from 2010 to 2017 : a Danish cohort study. / Helgestad, Ole K L; Josiassen, Jakob; Hassager, Christian; Jensen, Lisette O; Holmvang, Lene; Sørensen, Anne; Frydland, Martin; Lassen, Annmarie T; Udesen, Nanna L J; Schmidt, Henrik; Ravn, Hanne B; Møller, Jacob E.

In: European Journal of Heart Failure, Vol. 21, No. 11, 11.2019, p. 1370-1378.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Temporal trends in incidence and patient characteristics in cardiogenic shock following acute myocardial infarction from 2010 to 2017

T2 - a Danish cohort study

AU - Helgestad, Ole K L

AU - Josiassen, Jakob

AU - Hassager, Christian

AU - Jensen, Lisette O

AU - Holmvang, Lene

AU - Sørensen, Anne

AU - Frydland, Martin

AU - Lassen, Annmarie T

AU - Udesen, Nanna L J

AU - Schmidt, Henrik

AU - Ravn, Hanne B

AU - Møller, Jacob E

N1 - © 2019 The Authors. European Journal of Heart Failure © 2019 European Society of Cardiology.

PY - 2019/11

Y1 - 2019/11

N2 - Aim: We sought to describe the contemporary annual incidence of cardiogenic shock (CS) following acute myocardial infarction (AMICS), the proportion of patients developing CS following ST-elevation myocardial infarction (STEMI), and other temporal changes in AMICS in Denmark between 2010 and 2017. Methods and results: Medical records of patients suspected of having AMICS during 2010–2017 were reviewed to identify consecutive patients with AMICS in a cohort corresponding to two-thirds of the Danish population. Due to changes in recruitment area over the study period, population-based incidence could only be calculated from 2012 to 2017. A total of 1716 patients with AMICS were identified and an increase in the annual incidence was observed, from a nadir 65.3 per million person-years in 2013 to 80.0 per million person-years in 2017 (P-value for trend < 0.001). This trend corresponded to an increase in patients with non-STEMI and a decrease in patients developing CS after STEMI (10.0–6.6%, P-value for trend < 0.001) Also, mean arterial blood pressure at the time of AMICS was lower (63 ± 11 mmHg to 61 ± 13 mmHg, P-value for trend = 0.001) and the frequency of patients with left ventricular ejection fraction ≤ 30% increased (61.8%–71.4%, P-value for trend = 0.004). The annual 30-day mortality during the study period remained unchanged at about 50%. Conclusion: The incidence rate of AMICS increased in the Danish population between 2012 and 2017. Fewer patients with STEMI developed CS, and haemodynamic severity of CS increased during the study period; however, survival rates remained unchanged.

AB - Aim: We sought to describe the contemporary annual incidence of cardiogenic shock (CS) following acute myocardial infarction (AMICS), the proportion of patients developing CS following ST-elevation myocardial infarction (STEMI), and other temporal changes in AMICS in Denmark between 2010 and 2017. Methods and results: Medical records of patients suspected of having AMICS during 2010–2017 were reviewed to identify consecutive patients with AMICS in a cohort corresponding to two-thirds of the Danish population. Due to changes in recruitment area over the study period, population-based incidence could only be calculated from 2012 to 2017. A total of 1716 patients with AMICS were identified and an increase in the annual incidence was observed, from a nadir 65.3 per million person-years in 2013 to 80.0 per million person-years in 2017 (P-value for trend < 0.001). This trend corresponded to an increase in patients with non-STEMI and a decrease in patients developing CS after STEMI (10.0–6.6%, P-value for trend < 0.001) Also, mean arterial blood pressure at the time of AMICS was lower (63 ± 11 mmHg to 61 ± 13 mmHg, P-value for trend = 0.001) and the frequency of patients with left ventricular ejection fraction ≤ 30% increased (61.8%–71.4%, P-value for trend = 0.004). The annual 30-day mortality during the study period remained unchanged at about 50%. Conclusion: The incidence rate of AMICS increased in the Danish population between 2012 and 2017. Fewer patients with STEMI developed CS, and haemodynamic severity of CS increased during the study period; however, survival rates remained unchanged.

KW - Cardiogenic shock

KW - Epidemiology

KW - Mechanical circulatory support

KW - Myocardial infarction

KW - Percutaneous coronary intervention

U2 - 10.1002/ejhf.1566

DO - 10.1002/ejhf.1566

M3 - Journal article

C2 - 31339222

VL - 21

SP - 1370

EP - 1378

JO - European Journal of Heart Failure

JF - European Journal of Heart Failure

SN - 1388-9842

IS - 11

ER -