ClinicalAge adjusted nationwide trends in the incidence of all cause and ST elevation myocardial infarction associated cardiogenic shock based on gender and race in the United States

- We found that the incidence of cardiogenic shock (CS) in the setting of STEMI has been declining slowly over the last 10 years.
- This decline was persistent across different race or gender. However, female gender had persistently lower incident of age adjusted STEMI associated cardiogenic shock in comparison to male gender.
- This decline occurred regardless of race with persistently lower incidence of STEMI associated CS in African Americans similar to female gender.
- On the other hand, total incidence of all cause cardiogenic shocks has not changed over the years studied irrespective of race or gender.

BackgroundRecent 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.MethodThe 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.ResultsA 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.ConclusionAdvancement 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.