Characteristics, Treatment Strategies and Outcome in Cardiogenic Shock Complicating Acute Myocardial Infarction: A Contemporary Dutch Cohort.

Autor: Peters EJ; Heart Center, Department of Cardiology, Amsterdam University Medical Centers, 1105 AZ Amsterdam, The Netherlands., Berg ST; Heart Center, Department of Cardiology, Amsterdam University Medical Centers, 1105 AZ Amsterdam, The Netherlands., Bogerd M; Heart Center, Department of Cardiology, Amsterdam University Medical Centers, 1105 AZ Amsterdam, The Netherlands., Timmermans MJC; Netherlands Heart Registration, 3511 EP Utrecht, The Netherlands., Kraaijeveld AO; Department of Cardiology, Utrecht University Medical Center, 3584 CX Utrecht, The Netherlands., Bunge JJH; Department of Cardiology, Thoraxcenter, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands.; Department of Intensive Care Adults, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands., Teeuwen K; Heart Center, Department of Interventional Cardiology, Catharina Hospital Eindhoven, 5623 EJ Eindhoven, The Netherlands., Lipsic E; Department of Cardiology, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands., Sjauw KD; Heart Center, Medical Center Leeuwarden, 8934 AD Leeuwarden, The Netherlands., Geuns RMV; Department of Cardiology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands., Dedic A; Department of Cardiology, Noordwest Clinics, 1815 JD Alkmaar, The Netherlands., Dubois EA; Department of Cardiology, Thoraxcenter, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands.; Department of Intensive Care Adults, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands., Meuwissen M; Department of Cardiology, Amphia Hospital, 4818 CK Breda, The Netherlands., Danse P; Department of Cardiology, Rijnstate Hospital, 6815 AD Arnhem, The Netherlands., Verouden NJW; Heart Center, Department of Cardiology, Amsterdam University Medical Centers, 1105 AZ Amsterdam, The Netherlands., Bleeker G; Department of Cardiology, Haga Hospital, 2545 AA The Hague, The Netherlands., Cabezas JMM; Department of Cardiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands., Ferreira IA; Department of Cardiology, Isala Hospital, 8025 AB Zwolle, The Netherlands., Engström AE; Department of Intensive Care, Amsterdam University Medical Centers, 1105 AZ Amsterdam, The Netherlands., Lagrand WK; Department of Intensive Care, Amsterdam University Medical Centers, 1105 AZ Amsterdam, The Netherlands., Otterspoor LC; Department of Intensive Care Adults, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands.; Department of Intensive Care, Catharina Hospital, 5623 EJ Eindhoven, The Netherlands., Vlaar APJ; Department of Intensive Care, Amsterdam University Medical Centers, 1105 AZ Amsterdam, The Netherlands., Henriques JPS; Heart Center, Department of Cardiology, Amsterdam University Medical Centers, 1105 AZ Amsterdam, The Netherlands., On Behalf Of The Participating Centers Of The Pci Registration Committee Of The Netherlands Heart Registration
Jazyk: angličtina
Zdroj: Journal of clinical medicine [J Clin Med] 2023 Aug 10; Vol. 12 (16). Date of Electronic Publication: 2023 Aug 10.
DOI: 10.3390/jcm12165221
Abstrakt: Cardiogenic shock (CS) complicating acute myocardial infarction (AMI) is associated with high morbidity and mortality. Our study aimed to gain insights into patient characteristics, outcomes and treatment strategies in CS patients. Patients with CS who underwent percutaneous coronary intervention (PCI) between 2017 and 2021 were identified in a nationwide registry. Data on medical history, laboratory values, angiographic features and outcomes were retrospectively assessed. A total of 2328 patients with a mean age of 66 years and of whom 73% were male, were included. Mortality at 30 days was 39% for the entire cohort. Non-survivors presented with a lower mean blood pressure and increased heart rate, blood lactate and blood glucose levels ( p -value for all <0.001). Also, an increased prevalence of diabetes, multivessel coronary artery disease and a prior coronary event were found. Of all patients, 24% received mechanical circulatory support, of which the majority was via intra-aortic balloon pumps (IABPs). Furthermore, 79% of patients were treated with at least one vasoactive agent, and multivessel PCI was performed in 28%. In conclusion, a large set of hemodynamic, biochemical and patient-related characteristics was identified to be associated with mortality. Interestingly, multivessel PCI and IABPs were frequently applied despite a lack of evidence.
Databáze: MEDLINE
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