Cardiogenic shock (CS) and out-of-hospital cardiac arrest (OHCA) are events with profound implications for patient outcomes. We aim to analyze the predictors of CS and OHCA in patients with acute myocardial infarction and their effects on mortality. The analysis is based on data from a national registry between 2016 and 2020. A total of 23,703 patients with ST-elevation myocardial infarction (STEMI) were analyzed: (A) patients without CS and OHCA (19,590), (B) after OHCA (2,262), (C) with CS (713), and (D) after OHCA with CS (1,138). Patients after OHCA without CS had the lowest mean age [62.0 (± 12.6) years], while patients with CS without OHCA were the oldest [68.8 (± 11.8) years] and had the highest proportions of comorbidities. CS was a predictor of 30-day and 1-year mortality, with odds ratios [OR; 95% confidence intervals (CI)] of 5.52 (4.51; 6.75) and 4.66 (3.87; 5.61) for patients after OHCA, and OR (95% CI) 9.28 (7.56; 11.38) and 7.33 (6.04; 8.89) for those without OHCA. For overall survival up to 30 days and in comparison to patients without CS and OHCA, the hazard ratios (95% CI) was 2.77 (2.40; 3.20) for patients with OHCA only, 14.36 (12.57; 16.40) for patients with CS only, and 16.96 (15.19; 18.92) for patients with both CS and OHCA. OHCA altered the 30-day mortality risk after STEMI for both patients with and without CS. CS is a predictor of both 30-day and 1-year mortality in patients with STEMI, irrespective of OHCA status.

1st Department of Internal Medicine and Cardioangiology International Clinical Research Center Faculty of Medicine St Anne's University Hospital Masaryk University Brno Czech Republic

Cardiocenter Liberec Regional Hospital Liberec Czech Republic

Cardiocentre 3rd Faculty of Medicine Charles University and University Hospital Kralovske Vinohrady Srobarova 50 100 34 Prague Czech Republic

Department of Cardiology Faculty of Medicine University Hospital Charles University Pilsen Czech Republic

Department of Cardiology Hospital of Pardubice Pardubice Czech Republic

Department of Cardiology Krajska Zdravotni A S Masaryk Hospital Jan Evangelista Purkyne University Usti nad Labem Czech Republic

Department of Cardiology Nemocnice Agel Trinec Podlesi Trinec Czech Republic

Department of Cardiology T Bata Regional Hospital Zlin Czech Republic

Department of Cardiovascular Surgery University Hospital Ostrava Czech Republic

Department of Internal Medicine 1 and Cardiology Faculty of Medicine and Dentistry University Hospital Palacky University Olomouc Czech Republic

Department of Internal Medicine and Cardiology University Hospital Faculty of Medicine of Masaryk University Brno Czech Republic

Departmet of Cardiovascular Medicine University Hospital Hradec Kralove Czech Republic

Institute of Biostatistics and Analyses Faculty of Medicine Masaryk University Brno Czech Republic

Institute of Clinical and Experimental Medicine Cardiology Prague Czech Republic

Institute of Health Information and Statistics of the Czech Republic Prague Czech Republic

Regional Hospital Ceske Budejovice Czech Republic

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