Cardiogenic shock, however rare, can occur after a heart attack, exacerbating the effect of inadequate circulation on tissues after a loss of access to oxygen. Cardiogenic shock increases risk of death or rehospitalization for heart attack patients in the two months following their discharge, but a new study shows that this difference in risk diminishes after a full year passes.
Cardiogenic shock involves low blood pressure for at least half an hour, “often requiring the use of mechanical devices to sustain it at a safe level.” In a new study published in the Journal of the American College of Cardiology,
researchers looked at 112,561 heart attack patients over time, observing the difference between patients who remained healthy and those who did not.
Of the 112,561 total population of study participants, about five percent experienced cardiogenic shock during their initial hospitalization. These patients tended to be younger and “less likely to have had a previous heart attack, angioplasty, or coronary artery bypass graft surgery” than patients who did not experience a cardiogenic shock after their heart attack.
Of the approximately 5,600 heart attack patients with cardiogenic shock, 34 percent died or were rehospitalized 60 days after being discharged. Only 25 percent of non-shock patients had the same outcome after 60 days. However, after a full year had passed, the statistics were more equal, with 59 percent of cardiogenic shock patients and 52 percent of non-shock patients having died or being rehospitalized.
The researchers controlled for various potentially conflicted variables such as age, gender, hypertension, high cholesterol, chronic lung disease, hospital region and size, in-hospital events and interventions. With these variables under control, they were able to say for certain that patients who survived to 60 days have “similar outcomes regardless of shock status.”
"There is a need to address the vulnerable immediate post-hospital period,” said lead author Rashmee Shah, MD, from the University of Utah.
In addition, preventing cardiogenic shock could be a way to reduce the percentage of heart attack patients dying or being rehospitalized post-discharge from the hospital.
Source: American College of Cardiology