Abstract
A significant proportion of patients hospitalized for ST elevation myocardial infarction (STEMI) may develop cardiogenic shock (CS) after primary percutaneous coronary intervention (PCI). The identification of these patients would be very important in order to improve their outcomes. To identify the angiographic predictors for developing cardiogenic shock after PCI in patients with STEMI. A total of 352 consecutive patients were retrospectively enrolled in the PAMI registry of the cardiology B department of Fattouma Bourguiba university hospital between January 2000 and March 2017. Patients with hemodynamic instability at presentation prior to PCI were excluded. Among the 352 patients, a total of 35 patients (9.9%) developed cardiogenic shock after PCI. Mean age was 63.5 ± 9.4 years. There was no difference between male and female. Percutaneous coronary interventions were proposed for all patients and performed in a primary setting in 95.2%. Patients who developed CS after PCI had more frequently multivesel coronary artery disease, baseline thrombolysis in myocardial infarction (TIMI) flow grade < 3 and thrombus burden grade ≥ 3 ( P < 0.001 for all). The culprit lesion was the left main in 26.3% and left anterior descending artery in 42.7% ( P = 0.001 for both). Most patients had post PCI TIMI flow grade ≤ 2 ( P < 0.001). No-reflow phenomenon was significatively higher in patients who developed CS after PCI (35.6% vs. 7.2%; P < 0.001). On multivariate analysis, no-reflow phenomenon and multivessel disease were independent predictors of post-procedural CS. The total in-hospital mortality was 11.9% and mortality was significatively higher in patients who developed CS after PCI (64.3%; P < 0.001). Despite invasive management strategy, mortality of cardiogenic shock complicating STEMI after PCI remains high. The identification of these patients may help in preventing this complication.
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
