This retrospective National Inpatient Sample study included 226,570 adults hospitalized with myocardial infarction complicated by cardiogenic shock during 2016–2019; 4.8% had dementia. Patients with dementia received PCI (39.3% versus 55.0%) and circulatory support (23.7% versus 46.4%) less frequently than those without dementia. Dementia was associated with higher adjusted odds of in-hospital mortality (aOR 1.17, 95% CI 1.12–1.22) and major adverse cardiovascular and cerebrovascular events (aOR 1.13, 95% CI 1.09–1.18). Findings were consistent in propensity-matched pairs, although the observational design cannot establish whether treatment differences caused worse outcomes.
Dementia identified an AMICS population receiving less invasive and supportive care and experiencing worse adjusted in-hospital outcomes. These associations do not establish the reasons for treatment differences or their causal contribution to outcomes.
Study limitation: Retrospective, code-based observational data remain vulnerable to residual confounding despite multivariable adjustment and propensity matching.
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