Prognostic Analysis for Cardiogenic Shock in Patients with Acute Myocardial Infarction Receiving Percutaneous Coronary Intervention.

Mao-Jen Lin,Hau-De Lin,Chun-Yu Chen,Han-Ping Wu

doi:10.1155/2017/8530539

Abstract

Cardiogenic shock (CS) is uncommon in patients suffering from acute myocardial infarction (AMI). Long-term outcome and adverse predictors for outcomes in AMI patients with CS receiving percutaneous coronary interventions (PCI) are unclear. A total of 482 AMI patients who received PCI were collected, including 53 CS and 429 non-CS. Predictors for AMI patients with CS including recurrent MI, cardiovascular (CV) mortality, all-cause mortality, and repeated-PCI were analyzed. The CS group had a lower central systolic pressure and central diastolic pressure (both P < 0.001). AMI patients with hypertension history were less prone to develop CS (P < 0.001). Calcium channel blockers and statins were less frequently used by the CS group than the non-CS group (both P < 0.05) after discharge. Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) score, CV mortality, and all-cause mortality were higher in the CS group than the non-CS group (all P < 0.005). For patients with CS, stroke history was a predictor of recurrent MI (P = 0.036). CS, age, SYNTAX score, and diabetes were predictors of CV mortality (all P < 0.05). CS, age, SYNTAX score, and stroke history were predictors for all-cause mortality (all P < 0.05). CS, age, and current smoking were predictors for repeated-PCI (all P < 0.05).

Highlights

Cardiogenic shock (CS) is uncommon in patients with acute myocardial infarction (AMI)
The risk factors for recurrent myocardial infarction (MI), cardiovascular (CV) mortality, all-cause mortality, and repeated-percutaneous coronary intervention (PCI) in patients with AMI complicated by CS were analyzed
They were divided into two groups: patients with AMI complicated by CS and AMI patients without CS

Summary

Introduction

Cardiogenic shock (CS) is uncommon in patients with acute myocardial infarction (AMI). An AMI complicated by CS is a complex syndrome which may induce low cardiac output and hypotension resulting in multiorgan dysfunction and mortality. Even with the introduction of modern intensive care units (ICUs), advanced medical treatment, and invasive devices, the short-term mortality and morbidity of AMI complicated by CS remain high [1,2,3,4]. The mortality rate for AMI complicated by CS after early revascularization, including percutaneous coronary intervention (PCI), is approximately 40% to 60%. As for age and gender, patients with AMI complicated by CS who are older than 75 years of age may have a higher one-year mortality than their younger counterparts [5, 6]. Compared with men, women suffering from STEMI more often have concurrent CS, according to some studies [7]

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