Association of pre-hospital shock team implementation with outcomes in ST-segment elevation myocardial infarction patients

IF 3.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Problems in Cardiology Pub Date : 2026-05-01 Epub Date: 2026-01-20 DOI:10.1016/j.cpcardiol.2026.103274

Abdulrahman Arabi, Mhd Baraa Habib, Mohamed Salah Abdelghani, Osamah AlAmeen, Mohammad Al-Hijji, Awad Alqahtani, Salah Eddin Arafa, Ihsan Rafie, Jassim M.S. Al Suwaidi

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引用次数: 0

Abstract

Background

Cardiogenic shock (CS) complicating ST-segment elevation myocardial infarction (STEMI) is associated with high mortality rates. While in-hospital shock teams have shown benefits, the impact of pre-hospital shock team activation remains underexplored.

Methods

In July 2022, our high-volume primary percutaneous coronary intervention (PPCI) center serving the entire state population implemented a pre-hospital shock team. This multidisciplinary team comprises an emergency department physician, cardiac intensivist, interventional cardiologist, cardiac anesthesiologist, and extracorporeal membrane oxygenation (ECMO) specialists. Activation criteria include hypotension, tachycardia or bradycardia, acute heart failure, significant ST-elevation, ventricular arrhythmias, or elevated lactic acid levels. We compared mortality rates 18 months before and after implementation.

Results

Before implementation, 1,605 STEMI patients were admitted, compared to 1,735 after implementation. Of these, 217 (12%) met shock team activation criteria. Early Hospital mortality (in ED and in Cath lab) and Overall-hospital mortality rates significantly declined following implementation (1.2% vs. 0.3%, p = 0.03; and 2.1% vs. 3.3%, p = 0.02, respectively).

Conclusion

This study suggests that pre-hospital shock team implementation is associated with a significant reduction in STEMI mortality.

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院前休克小组实施与st段抬高型心肌梗死患者预后的关系

背景：心源性休克（CS）合并st段抬高型心肌梗死（STEMI）与高死亡率相关。虽然院内休克小组已显示出益处，但院前休克小组激活的影响仍未得到充分探讨。方法：2022年7月，我们为全州人口服务的大容量初级经皮冠状动脉介入治疗（PPCI）中心实施了院前休克小组。这个多学科团队包括急诊科医师、心脏强化医师、介入性心脏病专家、心脏麻醉师和体外膜氧合（ECMO）专家。激活标准包括低血压、心动过速或心动过缓、急性心力衰竭、明显st段抬高、室性心律失常或乳酸水平升高。我们比较了实施前后18个月的死亡率。结果：实施前，1605例STEMI患者入院，而实施后为1735例。其中，217人（12%）达到了突击队的激活标准。实施后，医院早期死亡率（急诊科和导管室）和医院整体死亡率显著下降（分别为1.2%对0.3%,p=0.03； 2.1%对3.3%,p=0.02）。结论：本研究表明院前休克小组实施与显著降低STEMI死亡率相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Problems in Cardiology 医学-心血管系统

CiteScore

4.80

自引率

2.40%

发文量

392

审稿时长

6 days

期刊介绍： Under the editorial leadership of noted cardiologist Dr. Hector O. Ventura, Current Problems in Cardiology provides focused, comprehensive coverage of important clinical topics in cardiology. Each monthly issues, addresses a selected clinical problem or condition, including pathophysiology, invasive and noninvasive diagnosis, drug therapy, surgical management, and rehabilitation; or explores the clinical applications of a diagnostic modality or a particular category of drugs. Critical commentary from the distinguished editorial board accompanies each monograph, providing readers with additional insights. An extensive bibliography in each issue saves hours of library research.