Deterioration of cardiogenic shock after acute myocardial infarction defined by the society for cardiovascular angiography and intervention cardiogenic shock classification scheme

Autor: T Mukaida, Y Kataoka, Y Murai, T Iwai, K Sawada, H Matama, S Honda, K Takagi, M Fujino, S Yoneda, F Otsuka, Y Tahara, Y Asaumi, T Noguchi
Rok vydání: 2022
Předmět:
Zdroj: European Heart Journal. 43
ISSN: 1522-9645
0195-668X
Popis: Background Cardiogenic shock (CS) in patients with AMI presents worse cardiovascular outcomes, which suggests the need for better risk stratification and management. The Society for Cardiovascular Angiography and Intervention (SCAI) has recently proposed CS classification scheme, which stratifies CS into 5 groups according to hypotension and hypoperfusion. While stage A and B exhibits CS without hypotension and/or hypoperfusion, their clinical condition could rapidly deteriorate into stage C-E. However, clinical characteristics and in-hospital outcomes of CS exhibiting its deterioration remains uncertain. Purpose To characterize AMI patients who deteriorated their CS status from stage A and B into stage C-E. Methods This single-center observational study included 326 consecutive AMI patients receiving primary PCI who presented CS stage A and B on arrival (2019.09.01–2021.09.30). Deterioration of CS (D-CS) was defined as the progression from stage A and B on arrival to stage C-E after primary PCI. Clinical characteristics and outcomes were compared in those with and without D-CS. Results D-CS was identified in 16.0% of entire subjects (=52/326). Of these, 94.2 and 5.8% of them exhibited stage C and E, respectively (Figure). Patients with D-CS more likely presented STEMI (84.6 vs. 67.9%, p=0.01) with a lower systolic BP (sBP) level (130±31 vs. 148±26mmHg, p Conclusion 16.0% of AMI without any hypotension/hypoperfusion on arrival exhibited deterioration of CS status on SCAI classification. The combination of sBP, LVEF and pre-TIMI flow grade could help to identify AMI subjects with a risk of D-CS, who may benefit from early adoption of intensified management including MCS prior to PCI. Funding Acknowledgement Type of funding sources: None.
Databáze: OpenAIRE
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