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Current problems in cardiology · 2026

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

СтатьяОбзорНазвание и аннотация: Перевод в очереди
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Arabi Abdulrahman, Habib Mhd Baraa, Abdelghani Mohamed Salah, AlAmeen Osamah, Al-Hijji Mohammad, Alqahtani Awad, Arafa Salah Eddin, Rafie Ihsan, Suwaidi Jassim M S Al

Аннотация

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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