Risk factors for cardiogenic shock incidence and mortality after acute myocardial infarction: a systematic review and meta-analysis.

backgroundCardiogenic shock (CS) is a serious complication of acute myocardial infarction (AMI), which could lead to severe health loss. This systematic review aimed to analyze the risk factors related to the incidence and poor outcomes of cardiogenic shock after acute myocardial infarction (AMI-CS), including in-hospital death, 30-day death and 1-year death.

methodsOriginal studies were systematically searched in PubMed and Embase up to November 2022. The summary odds ratio (OR) and 95% confidence interval (CI) of all studies were acquired based on a random effect model or fixed effect model. Subgroup analyses were conducted according to the study design, followed by sensitive analyses. The protocol was registered on PROSPERO (registration number: CRD42023466123).

resultsThere are 25 studies enrolled, including 12 cross-sectional studies, ten retrospective cohort studies, and three case-control studies. The pooled results reveal that female sex (OR, 1.10; 95% CI, 1.09-1.11), advanced age (OR, 1.06; 95% CI, 1.03-1.09), smoking (OR, 1.36; 95% CI, 1.26-1.45), diabetes (OR, 1.45; 95% CI, 1.08-1.82), and ST-segment elevation myocardial infarction (STEMI; OR, 1.99; 95% CI, 1.34-2.63) are significantly associated with the development of AMI-CS. Among these factors, all except smoking increase the risk of in-hospital death among AMI-CS patients. Advanced age (OR, 1.08; 95% CI, 1.04-1.12) and diabetes (OR, 1.77; 95% CI, 1.25-2.29) have negative impacts on 30-day death, while advanced age (OR, 2.10; 95% CI, 1.70-2.50) and STEMI (OR, 1.55; 95% CI, 1.15-1.95) are associated with 1-year death.

conclusionsOur findings highlight the significance of risk factors in predicting the incidence and prognosis of AMI-CS. Early identification and targeted interventions for individuals with these risk factors could potentially help prevent the occurrence of AMI-CS and improve patient outcomes.