Impact of Initial Heart Rate and Systolic Blood Pressure on Relation of Age and Mortality Among Fibrinolytic-Treated Patients With Acute ST-Elevation Myocardial Infarction Presenting With Cardiogenic Shock

Older age is associated with worse outcomes in patients with cardiogenic shock complicating ST-elevation myocardial infarction (STEMI). However, significant heterogeneity exists in different age groups with respect to outcomes. Identification of factors that modulate age-related risk of death in patients with cardiogenic shock may help clinical decision making and facilitate patient counseling. Accordingly, we evaluated 761 patients with STEMI who presented with cardiogenic shock and received fibrinolysis. We categorized patients into 3 age groups (80 mm Hg had substantial chance of recovery. In contrast, those with a systolic blood pressure ≤80 mm Hg and heart rate >100 beats/min had 30-day death rates >90% even if they were young. In conclusion, our data suggest that, although elderly patients with cardiogenic shock have poor prognosis, presenting heart rate and systolic blood pressure provide important information to differentiate who may have greater chance of recovery. This information may help physicians in deciding treatment options for patients with cardiogenic shock and counseling them about their risks.