PMID- 32279842
OWN - NLM
STAT- MEDLINE
DCOM- 20200828
LR  - 20200828
IS  - 1879-1913 (Electronic)
IS  - 0002-9149 (Linking)
VI  - 125
IP  - 11
DP  - 2020 Jun 1
TI  - Regional Variation in Procedural and Clinical Outcomes Among Patients With ST 
      Elevation Myocardial Infarction With Cardiogenic Shock.
PG  - 1612-1618
LID - S0002-9149(20)30207-1 [pii]
LID - 10.1016/j.amjcard.2020.02.033 [doi]
AB  - There is limited data on regional differences in patient characteristics, 
      practice patterns, and clinical outcomes in patients with ST elevation myocardial 
      infarction (STEMI) with cardiogenic shock (CS) in the United States (US). We 
      aimed to identify variations in treatment methods and clinical outcomes in 
      patients with STEMI CS between the 4 US regions. Using the National Inpatient 
      Sample database, we identified adult patients admitted with STEMI associated with 
      CS between 2006 and 2015 using ICD-9-DM codes. Based on the US regions 
      (Northeast, Midwest, South, and West), we divided patients in 4 cohorts and 
      compared baseline patient characteristics, clinical outcomes and procedural 
      outcomes. A total of 186,316 patients with STEMI CS were included; 32,303 (17.3%) 
      were hospitalized in the Northeast, 43,634 (23.4%) in the Midwest, 70,036 (37.8%) 
      in the South, and 40,043 (21.5%) in the West. Although nonstatistically 
      significant, the in-hospital mortality was higher in Northeast region (37.7%), 
      followed by the South (36.6%), West (35.7%), and Midwest (35.2%). Rates of 
      percutaneous coronary intervention were higher in the Midwest (68.5%) and lower 
      in the Northeast (56%). The use of percutaneous ventricular assist device and 
      ECMO was higher in the Northeast (3.3% and 2.2%) and lower in the West (2.1% and 
      0.4%). The median length of stay was similar among all 4 cohorts (6 days) but 
      median hospital costs were higher in the West ($36, 614) and lower in the South 
      ($28,795). In conclusion, there are significant geographic variations in practice 
      patterns, healthcare cost, and in-hospital outcomes in patients with STEMI 
      complicated by CS between 4 US regions.
CI  - Copyright (c) 2020 Elsevier Inc. All rights reserved.
FAU - Lemor, Alejandro
AU  - Lemor A
AD  - Division of Cardiology, Henry Ford Hospital, Detroit, Michigan; Centro de 
      Investigacion de Epidemiologia Clinica y Medicina Basada en la Evidencia, 
      Facultad de Medicina, Universidad de San Martin de Porres, Lima, Peru. Electronic 
      address: alejandrolemor@outlook.com.
FAU - Gorgis, Sarah
AU  - Gorgis S
AD  - Division of Cardiology, Henry Ford Hospital, Detroit, Michigan.
FAU - Villablanca, Pedro A
AU  - Villablanca PA
AD  - Division of Cardiology, Henry Ford Hospital, Detroit, Michigan.
FAU - Basir, Mir B
AU  - Basir MB
AD  - Division of Cardiology, Henry Ford Hospital, Detroit, Michigan.
FAU - Voeltz, Michele
AU  - Voeltz M
AD  - Division of Cardiology, Henry Ford Hospital, Detroit, Michigan.
FAU - Alaswad, Khaldoon
AU  - Alaswad K
AD  - Division of Cardiology, Henry Ford Hospital, Detroit, Michigan.
FAU - O'Neill, William
AU  - O'Neill W
AD  - Division of Cardiology, Henry Ford Hospital, Detroit, Michigan.
LA  - eng
PT  - Journal Article
DEP - 20200316
PL  - United States
TA  - Am J Cardiol
JT  - The American journal of cardiology
JID - 0207277
SB  - IM
MH  - Aged
MH  - Cardiac Catheterization/*statistics & numerical data
MH  - Cohort Studies
MH  - Comorbidity
MH  - Coronary Artery Bypass/*statistics & numerical data
MH  - Extracorporeal Membrane Oxygenation/*statistics & numerical data
MH  - Female
MH  - Geography
MH  - Health Care Costs/statistics & numerical data
MH  - Heart-Assist Devices/*statistics & numerical data
MH  - Hospital Costs/statistics & numerical data
MH  - Hospital Mortality
MH  - Humans
MH  - Intra-Aortic Balloon Pumping/*statistics & numerical data
MH  - Male
MH  - Percutaneous Coronary Intervention/*statistics & numerical data
MH  - Prognosis
MH  - ST Elevation Myocardial Infarction/complications/economics/mortality/*therapy
MH  - Shock, Cardiogenic/economics/etiology/mortality/*therapy
MH  - United States/epidemiology
EDAT- 2020/04/14 06:00
MHDA- 2020/08/29 06:00
CRDT- 2020/04/14 06:00
PHST- 2020/01/08 00:00 [received]
PHST- 2020/02/23 00:00 [revised]
PHST- 2020/02/27 00:00 [accepted]
PHST- 2020/04/14 06:00 [pubmed]
PHST- 2020/08/29 06:00 [medline]
PHST- 2020/04/14 06:00 [entrez]
AID - S0002-9149(20)30207-1 [pii]
AID - 10.1016/j.amjcard.2020.02.033 [doi]
PST - ppublish
SO  - Am J Cardiol. 2020 Jun 1;125(11):1612-1618. doi: 10.1016/j.amjcard.2020.02.033. 
      Epub 2020 Mar 16.