Objective: This study aims to investigate the prognostic impact of acute myocardial infarction (AMI) in patients with cardiogenic shock (CS).

Background: Prognosis of CS patients is unfavorable, despite improvements regarding their treatment. Limited data with respect to the prognostic impact of AMI in CS patients is available.

Methods: Consecutive patients admitted to an internistic invasive care unit (ICU) due to CS were monocentrically included from 2019 to 2021. The prognostic impact of AMI regarding 30-day all-cause mortality was analyzed within the entire study cohort. Thereafter, the prognostic impact of non-ST-segment myocardial infarction (NSTEMI) vs. ST-segment myocardial infarction (STEMI) was investigated. Statistical analyzes included univariable t-tests, Mann-Whitney U tests, Kaplan-Meier analyzes and Cox proportional regression analyzes.

Results: Within a total of 273 CS patients, 49% presented with AMI (76% STEMI, 24% NSTEMI) and 51% with non-AMI. The overall rate of 30-day all-cause mortality was 56%. Patients with AMI had an elevated risk of 30-day all-cause mortality compared to non-AMI patients (64% vs. 47%; log rank p=0.001; HR=1.653; 95% CI 1.199 – 2.281; p=0.002), even after multivariable adjustment (HR=1.526; 95% CI 1.018 – 2.287; p=0.041). Within AMI patients, no statistical significance between STEMI and NSTEMI was found with regard to 30-day all-cause mortality (63% vs. 69%; log rank p=0.528; HR=1.157; 95% CI 0.713-1.879; p=0.556).

Conclusion: AMI revealed impaired short-term prognosis compared to non-AMI in CS patients admitted to an internistic ICU, whereas the risk of mortality between STEMI and NSTEMI was comparable in AMI patients.