Cardiogenic Shock Predicts Long-term Mortality in Hospital Survivors of STEMI Treated With Primary Percutaneous Coronary Intervention

Autor: Arnoud W van 't Hof, Jan Henk Dambrink, Jan Paul Ottervanger, Marcel Gosselink, Veemal Hemradj, Elvin Kedhi, Harry Suryapranata
Rok vydání: 2016
Předmět:
Male
medicine.medical_specialty
Acute coronary syndrome
Time Factors
medicine.medical_treatment
Vascular damage Radboud Institute for Health Sciences [Radboudumc 16]
Shock
Cardiogenic
Clinical Investigations
Kaplan-Meier Estimate
030204 cardiovascular system & hematology
Risk Assessment
03 medical and health sciences
0302 clinical medicine
Percutaneous Coronary Intervention
Risk Factors
Internal medicine
Angioplasty
medicine
Humans
030212 general & internal medicine
Myocardial infarction
Hospital Mortality
Prospective Studies
Survivors
Prospective cohort study
Aged
Netherlands
Proportional Hazards Models
business.industry
Cardiogenic shock
Hazard ratio
Percutaneous coronary intervention
General Medicine
Middle Aged
medicine.disease
Treatment Outcome
Cohort
Multivariate Analysis
Cardiology
ST Elevation Myocardial Infarction
Female
Cardiology and Cardiovascular Medicine
business
Zdroj: Clinical Cardiology, 39, 11, pp. 665-669
Clinical Cardiology, 39, 665-669
ISSN: 1932-8737
0160-9289
Popis: Contains fulltext : 172076.pdf (Publisher’s version ) (Open Access) BACKGROUND: ST-segment elevation myocardial infarction (STEMI) complicated by cardiogenic shock (CS) has a poor prognosis. Recently published data suggested, however, that CS does not affect long-term mortality in hospital survivors of STEMI. We investigated whether this could be confirmed in a larger cohort. HYPOTHESIS: STEMI complicated by CS leads to worse long-term survival. METHODS: A prospective cohort study was performed in 7412 consecutive patients with STEMI treated by primary percutaneous coronary intervention (angioplasty). The predictive value of CS on long-term mortality was assessed in hospital survivors. Multivariate analysis, adjusting for differences in baseline variables, was performed to assess the independent prognostic value of CS. RESULTS: Cardiogenic shock was observed in 387 patients (5.2%). The total in-hospital mortality was 254 (3.4%), and mortality was significantly higher in patients with CS (20.0% vs 2.6%; P < 0.001). The 1-year mortality in hospital survivors was 10.3% in patients with CS and 3.9% in patients without CS (P < 0.001). After multivariate analysis, CS was still a significant predictor of long-term mortality in hospital survivors (hazard ratio: 2.6, 95% confidence interval: 1.64-4.01). CONCLUSIONS: Cardiogenic shock remains a strong predictor of long-term mortality in hospital survivors of STEMI treated by primary percutaneous coronary intervention.
Databáze: OpenAIRE
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