Acute Ischemic Heart DiseaseRecent magnitude of and temporal trends (1994-1997) in the incidence and hospital death rates of cardiogenic shock complicating acute myocardial infarction: The second National Registry of Myocardial Infarction☆
Section snippets
Methods
The Second National Registry of Myocardial Infarction (NRMI-2) is a cross-sectional observational study of patients hospitalized with AMI throughout the United States that has been ongoing since 1994. This voluntary registry of patients with AMI is sponsored by Genentech, Inc. The data collection process at each site and quality control features of the NRMI-2 have been previously described.17, 18 The purpose of NRMI-2 is to monitor trends in national treatment practices in patients hospitalized
Incidence rates of cardiogenic shock
A total of 426,253 patients with AMI were enrolled in the registry over the 4-year period under study; this included 45,860 in 1994, 120,136 in 1995, 130,426 in 1996, and 129,831 in 1997. Fewer patients were studied in 1994 because of closing of the NRMI-1 registry and beginning of new data collection activities for NRMI-2. The overall percentage of patients with AMI having cardiogenic shock was 6.2%. There was suggestion of a slight decline in the percentage of AMI patients with cardiogenic
Discussion
The results of this large observational study in patients hospitalized with AMI in nearly one fourth of all US hospitals suggest slight declines in the proportion of patients with AMI having cardiogenic shock and encouraging declines in hospital mortality associated with cardiogenic shock although these death rates remain markedly elevated in comparison to AMI patients not having shock.
The incidence of cardiogenic shock after AMI ranges between 5% and 15% in published studies. This relatively
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Reprint requests: Robert Goldberg, PhD, Department of Medicine, Division of Cardiovascular Medicine, University of Massachusetts Medical Schoool, 55 Lake Ave N, Worcester, MA 01655. E-mail: [email protected]