In-hospital mortality in cardiogenic shock complicating a STEMI: MIRAMI registry

Introduction Cardiogenic shock (CC) is a devastating complication of the ST elevation acute myocardial infarction (STEMI). Its mortality remains high despite the huge progress in critical care and coronary revascularization. Purpose We aim in this study to evaluate in-hospital mortality and its predicting factors in cardiogenic shock complicating a STEMI. Materials and methods It is a retrospective, mono-centric study including 267 patients from the MIRAMI registry who presented a CC-STEMI between 1995 and 2016. Results In-hospital mortality rate from all causes was 49.1% with a slight non-significant raise tendency over the study years (P = 0.299). The major cause was primary left ventricle dysfunction (61%) and death occurred within the first 24 hours in almost half of cases (49.2%). In uni-variate analysis, in-hospital mortality was more often in autumn (P = 0.033), among females (P = 0.001) and in elderly (P = 0.019). The major clinical mortality predicting factors were: hypertension (P   60 min (P = 0.034), a delay from symptoms onset to hospitalization > 6 hours (P = 0.034), anterior territory of the STEMI (P = 0.006) and Q wave on ECG (P = 0.043). Biological predicting factors were: anemia (P = 0.001), renal dysfunction (P  Conclusion In hospital mortality in CS-STEMI remains high even in literature so that the treatment strategy should be based on an urgent and multi-disciplinary approach.