AIMS Few studies describe recent changes in the prevalence, management, and outcomes of cardiogenic shock (CS) patients complicating acute myocardial infarction (AMI) in the era of widespread use of invasive strategies. The aim of the present study was to analyse trends observed in CS complicating AMI over the past 10 years, focusing on the timing of CS occurrence (i.e. primary CS, CS on admission vs. secondary CS, CS developed subsequently during hospitalization). METHODS AND RESULTS Three nationwide French registries conducted and designed to evaluate AMI management and outcomes in 'real-life' practice included consecutive AMI patients (n = 9951) admitted to intensive cardiovascular care units (ICCUs) over a 1-month period, 5 years apart. The prevalence of CS complicating AMI decreased from 2005 to 2015: 5.9%, mean age 74.1 ± 12.7 in 2005; 4.0%, mean age 73.9 ± 12.7 in 2010, 2.8%, mean age 71.1 ± 15.0 in 2015 (P < 0.001). It decreased for both primary (1.8% to 1.0%) and secondary CS (4.1% to 1.8%). The profile of CS patients also changed over time with more patients presenting out-of-hospital cardiac arrest. In both primary and secondary CS, the use of percutaneous coronary intervention increased markedly over time, as did the use of mechanical ventilation and cardiac assist devices. Over the 10-year period, in-hospital mortality remained unchanged for both primary CS (41.8% to 37.8%) or secondary CS (57.3% to 58.8%). However, 1-year mortality decreased in patients with primary CS (from 60% to 37.8%, P = 0.038), and remained unchanged in patients developing secondary CS (from 64.5% to 69.1%, P = 0.731). CONCLUSION Cardiogenic shock complicating AMI has become less frequent but, if present, CS, and particularly secondary CS, carries a very high mortality, which has not substantially improved over the past 10 years, in spite of the more frequent use of invasive strategies.

中文翻译：

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心源性休克的趋势使急性心肌梗塞复杂化。

AIMS很少有研究描述在侵入性策略广泛使用的时代，使急性心肌梗死（AMI）并发的心源性休克（CS）患者的患病率，治疗和结局的最新变化。本研究的目的是分析过去10年在CS并发AMI中观察到的趋势，重点是CS发生的时间（即，原发性CS，入院CS与继发性CS，住院期间随后发生的CS）。方法和结果进行了三个旨在评估“现实生活”实践中的AMI管理和结果的法国全国注册中心，其中包括在1个月（5年）内接受重症监护病房（ICCU）的连续AMI患者（n = 9951）分开。从2005年到2015年，CS并发AMI的患病率下降了5.9％，平均年龄为74.1±12。2005年为7；2010年为4.0％，平均年龄为73.9±12.7，2015年为2.8％，平均年龄为71.1±15.0（P <0.001）。初级CS（1.8％至1.0％）和次级CS（4.1％至1.8％）均下降。随着时间的推移，CS患者的状况也发生了变化，更多的患者出现了院外心脏骤停。在原发性和继发性CS中，经皮冠状动脉介入治疗的使用随着时间的推移显着增加，机械通气和心脏辅助设备的使用也随时间增加。在10年期间，无论是原发性CS（41.8％至37.8％）还是继发性CS（57.3％至58.8％）的院内死亡率均保持不变。然而，原发性CS患者的1年死亡率降低（从60％降至37.8％，P = 0.038），而发生原发性CS的患者则保持不变（从64.5％降至69.1％，P = 0.731）。