A Risky Time for Cardiogenic Shock Patients

Heart attack patients with cardiogenic shock may have higher death, rehospitalization risk

(RxWiki News) After surviving a heart attack, the last thing most patients want is to be readmitted to the hospital. One condition may make it more likely for them to do so.

A new study found that heart attack patients who developed cardiogenic shock were at a higher risk for re-hospitalization and death than other patients — but only at first. After 60 days, the gap between the groups narrowed.

Cardiogenic shock is a dramatic drop in blood pressure that lasts for thirty minutes or longer, causing inadequate blood circulation. It is often fatal if left untreated.

To arrive at this conclusion, researchers looked at the medical records of more than 100,000 heart attack patients treated at 677 US hospitals between January 2007 and September 2012. Of these patients, 5 percent developed cardiogenic shock during their initial hospitalization.

Researchers found that cardiogenic shock patients tended to be younger than patients without the condition. They were also less likely to have a history of heart attack, angioplasty or bypass surgery.

At 60 days post-discharge, 34 percent of the cardiogenic shock patients had either been re-hospitalized or had died. By comparison, 25 percent of the non-cardiogenic shock patients had done the same.

After one year, researchers noticed the numbers beginning to balance out.

At one year post-discharge, 59 percent of the cardiogenic shock patients had either died or been re-hospitalized. That figure was 52 percent for the non-cardiogenic shock patients.

Lead study author Rashmee Shah, MD, said there is a need to address this vulnerable period for heart attack patients with cardiogenic shock. Dr. Shah is a professor of internal medicine at the University of Utah.

"Future investigations should identify reasons for this pattern so that interventions could be tailored to improve early survival and identify the sickest patients, who may be better served with palliative care or hospice," Dr. Shah said in a press release.

Adnan Kastrati, MD, who was not involved in this study, said these findings support the theory that survival in heart attack patients is determined mostly by the extent of the damage to the heart muscle.

"This should motivate us to search for potentially modifiable factors that may lead to improved outcomes [for cardiac shock patients]," Dr. Kastrati wrote. Dr. Kastrati is a professor of medicine at the German Heart Center in Munich.

Talk to your doctor or pharmacist if you have any questions about the risk factors for heart disease.

This study was published Feb. 23 in the Journal of the American College of Cardiology.

No funding sources or conflicts of interest were disclosed.

Review Date: 
February 17, 2016