Maimaitiming Mailikezhati, Li Siwen, Huang Kepei, Maimaitiming Mulatijiang, Liu Feng, Smith Sidney C, Zheng Zhi-Jie, Jin Yinzi
Department of Global Health, School of Public Health, Peking University, Beijing, China.
Institute for Global Health and Development, Peking University, Beijing, China.
Commun Med (Lond). 2025 May 27;5(1):200. doi: 10.1038/s43856-025-00874-y.
Cardiogenic shock (CS) is a serious complication of acute myocardial infarction (AMI), which could lead to severe health loss. This systematic review aimed to analyze the risk factors related to the incidence and poor outcomes of cardiogenic shock after acute myocardial infarction (AMI-CS), including in-hospital death, 30-day death and 1-year death.
Original studies were systematically searched in PubMed and Embase up to November 2022. The summary odds ratio (OR) and 95% confidence interval (CI) of all studies were acquired based on a random effect model or fixed effect model. Subgroup analyses were conducted according to the study design, followed by sensitive analyses. The protocol was registered on PROSPERO (registration number: CRD42023466123).
There are 25 studies enrolled, including 12 cross-sectional studies, ten retrospective cohort studies, and three case-control studies. The pooled results reveal that female sex (OR, 1.10; 95% CI, 1.09-1.11), advanced age (OR, 1.06; 95% CI, 1.03-1.09), smoking (OR, 1.36; 95% CI, 1.26-1.45), diabetes (OR, 1.45; 95% CI, 1.08-1.82), and ST-segment elevation myocardial infarction (STEMI; OR, 1.99; 95% CI, 1.34-2.63) are significantly associated with the development of AMI-CS. Among these factors, all except smoking increase the risk of in-hospital death among AMI-CS patients. Advanced age (OR, 1.08; 95% CI, 1.04-1.12) and diabetes (OR, 1.77; 95% CI, 1.25-2.29) have negative impacts on 30-day death, while advanced age (OR, 2.10; 95% CI, 1.70-2.50) and STEMI (OR, 1.55; 95% CI, 1.15-1.95) are associated with 1-year death.
Our findings highlight the significance of risk factors in predicting the incidence and prognosis of AMI-CS. Early identification and targeted interventions for individuals with these risk factors could potentially help prevent the occurrence of AMI-CS and improve patient outcomes.
心源性休克（CS）是急性心肌梗死（AMI）的一种严重并发症，可导致严重的健康损失。本系统评价旨在分析与急性心肌梗死后心源性休克（AMI-CS）的发生率和不良结局相关的危险因素，包括院内死亡、30天死亡和1年死亡。
截至2022年11月，在PubMed和Embase中系统检索原始研究。基于随机效应模型或固定效应模型获取所有研究的汇总比值比（OR）和95%置信区间（CI）。根据研究设计进行亚组分析，随后进行敏感性分析。该方案已在PROSPERO上注册（注册号：CRD42023466123）。
共纳入25项研究，包括12项横断面研究、10项回顾性队列研究和3项病例对照研究。汇总结果显示，女性（OR，1.10；95%CI，1.09-1.11）、高龄（OR，1.06；95%CI，1.03-1.09）、吸烟（OR，1.36；95%CI，1.26-1.45）、糖尿病（OR，1.45；95%CI，1.08-1.82）和ST段抬高型心肌梗死（STEMI；OR，1.99；95%CI，1.34-2.63）与AMI-CS的发生显著相关。在这些因素中，除吸烟外，所有因素均增加了AMI-CS患者的院内死亡风险。高龄（OR，1.08；95%CI，1.04-1.12）和糖尿病（OR，1.77；95%CI，1.25-2.29）对30天死亡有负面影响，而高龄（OR，2.10；95%CI，1.70-2.50）和STEMI（OR，1.55；95%CI，1.15-1.95）与1年死亡相关。
我们的研究结果强调了危险因素在预测AMI-CS的发生率和预后方面的重要性。对具有这些危险因素的个体进行早期识别和针对性干预可能有助于预防AMI-CS的发生并改善患者结局。
