Analysis of risk factors of cardiogenic shock secondary to acute myocardial infarction

Abstract

To explore risk factors for cardiogenic shock (CS) secondary to acute myocardial infarction (AMI) patients arising from comorbidities so as to identify high risk patients earlier. A retrospective study was conducted on 5523 patients who were hospitalized with AMI in PLA General Hospital from January 1993 to December 2009. The patients were divided into two groups based on presence or absence of CS. Logistic regression analysis was used from comorbidities to evaluate the independent risk factors for CS. Among 5523 hospitalized AMI patients, 197 (3.57%) developed CS. The 30-day in hospital mortality rate of CS group was significantly higher than that of non-CS group [55.33% (109/197) vs. 7.49% (399/5326), P<0.001]. On the basis of logistic regression analysis, advanced age [odds ratio (OR)=1.03, 95% confidence interval (95%CI) 1.02 - 1.05, P<0.001], previous attack of myocardial infarction (OR=1.57, 95%CI 1.13 - 2.19, P=0.007), history of stroke (OR=1.98, 95%CI 1.20 - 3.27, P=0.008), chronic renal failure (OR=1.76, 95%CI 1.23 - 2.51, P=0.002) and pneumonia (OR=1.72, 95%CI 1.17 - 2.52, P=0.006) were independent risk factors for CS. Using receiver operator characteristic curve (ROC curve) analysis, the model was shown a good quality to judge the outcome of CS patients as the area under curve equals 0.81 (95%CI 0.75 - 0.85, P<0.001). Advanced age and comorbidities including previous myocardial infarction, previous stroke, chronic renal failure and pneumonia were independent risk factors for CS.