0321 : Cardiogenic shock in acute myocardial infarction. The experience of the military hospital. About (7)0 cases

Abstract

Cardiogenic shock remains the leading cause of death in the acute phase of myocardial infarction (MI); it is the result of myocardial and / or mechanical failure complication. The aim of our study was to investigate the epidemiological, clinical and support of a serie of patients hospitalized for MI complicated by cardiogenic shock as well as the immediate and late prognosis. It was a single-center retrospective study of 70 patients hospitalized in the service of cardiology of the military hospital for myocardial infarction complicated by cardiogenic shock, between 2005 and 2012. The mean age was 63 ± 10 years, 80% were men. The majority of myocardial infarction were anteriors. On admission 41% were in left ventricular failure, and 59% in shock. Thrombolysis was performed in 51% of patients. Angiography had identified a single truncal achieved in 28% of cases, bi -vessel in 44% of cases and tri- truncal in 28% of cases. The transcoronary angiolpasty was primary in 27% of cases and of rescue in 73% of cases. Revascularization was complete in 37% of cases. The success rate of TCA was 85%. The majority of bare stents were used (83%). The mean LVEF was 49 ± 14.4%. 70% of patients received vasopressor therapy with a mean duration of 3.5 days. IABP was placed in 2 patients with an average duration of 2 days. The average of hospital stay was 7 ± 8 days. Hospital mortality was 47%, occurring on average in the sixth day of hospitalization (6±9 days). We found that renal failure, late onset of shock, hyperglycemia, leukocytosis, use of vasopressors, and the anterior territory of MI were significantly predictive of hospital mortality. Despite significant advances in the treatment of myocardial infarction, particularly techniques of reperfusion, therapeutic drug, and the advent of several circulatory support techniques, mortality of cardiogenic shock in acute phase of myocardial infarction remains high. The author hereby declares no conflict of interest