Abstract 4501: Decreasing In-hospital Mortality With Increasing Rate of Early PCI in Patients With ST Elevation Myocardial Infarction Complicated by Cardiogenic Shock: Results of the MITRA-Plus Registry
Background: STEMI complicated by cardiogenic shock is associated with a high in-hospital mortality. In the randomised SHOCK trial an early invasive strategy has improved the prognosis of these patients. Aim of our study was to evaluate the influence of early PCI on mortality in patients with cardiogenic shock in clinical practice.
Methods: In the prospective MITRA-Plus registry patients with STEMI <24 hours were enrolled between 1994 and 2008. In this analysis the rate of early PCI within 24 hours after admission during different periods and the in-hospital mortality rates were studied.
Results: During the whole study period the incidence of cardiogenic shock was 9.1%. The rate of early PCI increased significantly between 1994 and 2008 from 9.6% to 77.3% (p for trend <0.0001). This was associated with a significant decrease of in-hospital mortality from 72.2% to 40.7% (p for trend <0.0001) (Table⇓).
Conclusions: In clinical practice we observed a significant increase of early PCI in patients with STEMI complicated by cardiogenic shock over the last 15 years. In concordance with the results of the randomised SHOCK trial this was associated with a decrease of in-hospital mortality and underscores the importance of an early invasive strategy in these high risk patients.