Movahed Mohammad Reza, Khan Muhammad F, Hashemzadeh Mehrnoosh, Hashemzadeh Mehrtash
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.
Division of Cardiology, The Southern Arizona VA health Care system, Tucson, Arizona.
Cardiovasc Revasc Med. 2015 Jan-Feb;16(1):2-5. doi: 10.1016/j.carrev.2014.07.007. Epub 2014 Oct 22.
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.
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.
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.
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.
近期心肌梗死患者护理方面的改善应能带来更好的治疗结果。本研究的目的是评估美国全因心源性休克（CS）以及ST段抬高型心肌梗死（STEMI）背景下发生的心源性休克的发生率。
利用全国住院患者样本（NIS）数据库，根据1996年至2006年STEMI背景下的国际疾病分类第九版（ICD - 9）编码计算CS的年龄调整发病率。此外，我们还根据种族和性别评估了这一趋势。
1996年至2006年期间共有52784917例患者。我们发现全因心源性休克的发生率并未随时间变化。然而，在STEMI背景下，心源性休克在过去10年中一直在缓慢下降。1996年CS的年龄调整发病率为每10万人4.3例，到2006年保持稳定，发病率为每10万人3.1例（p<0.01）。这种下降在不同种族或性别中持续存在。然而，非裔美国人和女性的心源性休克发生率一直较低。
急性STEMI治疗的进展导致STEMI相关心源性休克的发生率逐渐降低，无论种族或性别如何，这表明近年来STEMI患者的治疗结果有所改善。
