{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T16:06:02Z","timestamp":1784131562849,"version":"3.55.0"},"reference-count":35,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To examine treatment trends and outcomes over time for patients with ST\u2010elevation myocardial infarction\u2010related cardiogenic shock (STEMI\u2010CS) in a regional centre.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>This retrospective study analysed data from patients with STEMI and Killip class IV cardiogenic shock at a Victorian regional tertiary hospital over 10\u2009years (2014\u20132024). Patients treated with percutaneous coronary intervention (PCI) or surgical revascularisation (coronary artery bypass grafting) were identified using state\u2010wide registries. The primary outcome was 30\u2010day mortality with secondary outcomes of door\u2010to\u2010balloon time, mechanical circulatory support (MCS) use, ICU\/hospital length of stay and revascularisation technique.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>One hundred and seventy\u2010two adult patients (74% male) had STEMI\u2010CS. The number of patients presenting with STEMI\u2010CS increased over the 10\u2010year period; however, 30\u2010day mortality remained unchanged at 49%. In addition, 69% achieved a door\u2010to\u2010balloon time &lt;90 min, and the median door\u2010to\u2010balloon time did not differ significantly over time. However, 19% required MCS, with similar numbers for intra\u2010aortic balloon pump and extra (corporeal membrane oxygenation. The median intensive care unit\u00a0and hospital length of stay was 5\u2009days (IQR\u2009=\u20092\u20139) and 8\u2009days (IQR\u2009=\u20093\u201313) respectively and was unchanged over time. There was a strongly positive and statistically significant trend towards increased use of PCI over the 10\u2010year study period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>With timely revascularisation and increasing use of PCI, STEMI\u2010CS patients in regional settings with access to a 24\u2010h catheter lab have outcomes consistent with metropolitan and global trends. Despite medical advancements, outcomes for patients with STEMI\u2010CS are largely unchanged over time, with 30\u2010day mortality rates that remain unacceptably high. There is an urgent need for innovative strategies and system\u2010level improvements to address the increasing burden of STEMI\u2010CS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/imj.70554","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T15:14:29Z","timestamp":1784128469000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The evolving treatment and outcomes of patients presenting with\n                    <scp>STEMI<\/scp>\n                    and cardiogenic shock: a regional experience"],"prefix":"10.1111","author":[{"given":"Anita","family":"Shirwaiker","sequence":"first","affiliation":[{"name":"Department of Cardiology University Hospital Geelong  Geelong Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Henderson","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Hospital Geelong  Geelong Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"McLarty","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine University Hospital Geelong  Geelong Victoria Australia"},{"name":"Australia and New Zealand Intensive Care Research Centre Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Udit","family":"Thakur","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Hospital Geelong  Geelong Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Hutchison","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Hospital Geelong  Geelong Victoria Australia"},{"name":"School of Medicine Deakin University  Geelong Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chin","family":"Hiew","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Hospital Geelong  Geelong Victoria Australia"},{"name":"School of Medicine Deakin University  Geelong Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,15]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"crossref","first-page":"2671","DOI":"10.1093\/eurheartj\/ehz363","article-title":"Management of cardiogenic shock complicating myocardial infarction: an update 2019","volume":"40","author":"Thiele H","year":"2019","journal-title":"Eur Heart J"},{"key":"e_1_2_9_3_1","doi-asserted-by":"crossref","first-page":"1286","DOI":"10.1056\/NEJMoa2307227","article-title":"Extracorporeal life support in infarct\u2010related cardiogenic shock","volume":"389","author":"Thiele H","year":"2023","journal-title":"N Engl J Med"},{"key":"e_1_2_9_4_1","doi-asserted-by":"crossref","DOI":"10.3390\/jcm11123558","article-title":"Non\u2010STEMI vs. STEMI cardiogenic shock: clinical profile and long\u2010term outcomes","volume":"11","author":"Martinez MJ","year":"2022","journal-title":"J Clin Med"},{"key":"e_1_2_9_5_1","first-page":"120","article-title":"Incidence and outcome of peri\u2010procedural cardiogenic shock: results from the international euro heart survey PCI registry","volume":"9","author":"Weipert KF","year":"2020","journal-title":"Eur Heart J Acute Cardiovasc Care"},{"key":"e_1_2_9_6_1","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.113.000590","article-title":"Trends in incidence, management, and outcomes of cardiogenic shock complicating ST\u2010elevation myocardial infarction in the United States","volume":"3","author":"Kolte D","year":"2014","journal-title":"J Am Heart Assoc"},{"key":"e_1_2_9_7_1","first-page":"422","article-title":"Impact of annual volume of cases and intensive cardiac care unit availability on mortality of patients with acute myocardial infarction\u2010related cardiogenic shock treated at revascularization capable centres","volume":"12","author":"Barrionuevo\u2010Sanchez MI","year":"2023","journal-title":"Eur Heart J Acute Cardiovasc Care"},{"key":"e_1_2_9_8_1","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.114.001462","article-title":"Effect of cardiogenic shock hospital volume on mortality in patients with cardiogenic shock","volume":"4","author":"Shaefi S","year":"2015","journal-title":"J Am Heart Assoc"},{"key":"e_1_2_9_9_1","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1016\/0002-9149(67)90023-9","article-title":"Treatment of myocardial infarction in a coronary care unit. A two year experience with 250 patients","volume":"20","author":"Killip T","year":"1967","journal-title":"Am J Cardiol"},{"key":"e_1_2_9_10_1","first-page":"E257","article-title":"Outcomes of cardiogenic shock complicating acute coronary syndromes","volume":"96","author":"Noaman S","year":"2020","journal-title":"Catheter Cardiovasc Interv"},{"key":"e_1_2_9_11_1","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1016\/j.hlc.2024.01.009","article-title":"Cardiogenic shock prior to percutaneous coronary intervention in ST\u2010elevation myocardial infarction: outcomes and predictors of mortality (ANZACS\u2010QI 73)","volume":"33","author":"Lee KH","year":"2024","journal-title":"Heart Lung Circ"},{"key":"e_1_2_9_12_1","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1056\/NEJM199908263410901","article-title":"Early revascularization in acute myocardial infarction complicated by cardiogenic SHOCK. SHOCK investigators. 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