In-hospital treatment outcomes of unselected patients with myocardial infarction-related cardiogenic shock and non myocardial infarction-related cardiogenic shock: The experience of the last 11 years of the Zabrze Cardiogenic Shock Center

Background: Cardiogenic shock (CS) is a critical clinical situation with high in-hospital mortality. Aims: The aim of the study was to compare clinical characteristics, management and in-hospital outcomes of patients with myocardial infarction (MI) complicated by CS (MI-CS) and non-MI-related CS treated in the highest level of reference center with complete diagnostic and therapeutic facilities. Methods: The study included consecutive patients with CS treated in a highest level of reference cardiological center with complete diagnostic and therapeutic facilities. Results: Between 2013 and 2024, among 1784 patients with CS treated in the Silesian Center for Heart Diseases, Zabrze, Poland, 777 (43.6%) had MI-CS and 1007 (56.4%) non-MI-related CS. Patients with MI-CS, compared to those with non-MI-related CS, were older, (69.7 [10.8] vs. 63.4 [14.1] years; P <0.001) with a greater prevalence of arterial hypertension (78.3% vs. 65.0%; P <0.001), diabetes (43.0% vs. 29.8%; P <0.001), and previous MI (64.8% vs. 28.2%; P <0.001). MI-CS patients were more frequently treated with intra-aortic balloon pump (46.8% vs. 31.9%; P <0.001) and less with extracorporeal membrane oxygenation (6.9% vs. 15.7%; P <0.001) and left ventricular assist device (0.0% vs. 2.6%; P <0.001). Patients with MI-CS compared to those with non-MI-related CS had lower in-hospital mortality (60.7% vs. 67.1%; P = 0.01, respectively). Conclusions: Patients with CS had numerous comorbidities before hospitalization including previous MI and heart failure. Patients with MI-CS constituted less than half of all patients and compared to those with non-MI-CS differed in terms of average age, clinical profile and management. Patients with non-MI-CS had significantly higher in-hospital mortality. The need for extracorporeal membrane oxygenation support and out-of-hospital cardiac arrest were the strongest independent predictors of in-hospital mortality.