Left ventricular support device for cardiogenic shock during myocardial infarction due to stent thrombosis: A single centre experience
| Autor: | Tania Chechi, Federica Giannotti, Lorenzo Consoli, Gabriele Giuliani, Giorgio Baldereschi, Alessio Lilli, Massimo Margheri, Gaia Spaziani, Guido Vittori, Sabine Vecchio |
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| Rok vydání: | 2011 |
| Předmět: |
medicine.medical_specialty
Databases Factual medicine.medical_treatment Myocardial Infarction Shock Cardiogenic Revascularization Ventricular Dysfunction Left Internal medicine medicine Humans Prospective Studies cardiovascular diseases Myocardial infarction Thrombus Impella Aged business.industry Cardiogenic shock Drug-Eluting Stents Thrombosis Middle Aged medicine.disease Defibrillators Implantable Surgery surgical procedures operative Shock (circulatory) Conventional PCI Cardiology Stents medicine.symptom Cardiology and Cardiovascular Medicine business TIMI Follow-Up Studies |
| Zdroj: | International Journal of Cardiology. 148:337-340 |
| ISSN: | 0167-5273 |
| Popis: | Background Stent thrombosis (ST) is a new, rare, cause of STEMI. Few data are available about incidence and clinical impact of shock complicating acute myocardial infarction due to ST (st-STEMI). Methods From January 2004 to March 2007, 92 st-STEMI patients were observed: 14 (15.2%) of them presented with cardiogenic shock and were evaluated in the present analysis. In particular, clinical and angiographic characteristics of survivors and non-survivors to PCI were compared. Results St-STEMI was related to left main or multivessels stent thrombosis in 35.7% of cases; whereas in 93% of cases st-STEMI occurred in a territory with previous myocardial infarction. All patients underwent IABP implantation immediately before coronary angiography, whereas Impella LP 2.5 pump was used in 21% of cases when persistent cardiac low-output signs were recorded. PCI was successful in 80% of cases. In-hospital survival was 28.6%. Death occurred within the first 48h in the majority of patients. At six-months all patients survived to the acute phase were alive. Survivors had significantly lower thrombus grade after wire passage ( p =0.03) and, albeit not significant, they showed a higher rate of very late ST, longer times from symptoms onset to revascularization, and higher TIMI flow grade either before and after PCI. Conclusion The incidence of cardiogenic shock in st-STEMI is high, particulary it seems to be two times higher than the rate reported during myocardial infarction. One third of cases is related to left main or multiple vessels ST. Shock in st-STEMI represents a dramatic event with very low in-hospital and early survival. |
| Databáze: | OpenAIRE |
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