Outcomes of cardiogenic shock complicating acute coronary syndromes.
Catheter Cardiovasc Interv
; 96(3): E257-E267, 2020 09 01.
Article
em En
| MEDLINE
| ID: mdl-32017332
ABSTRACT
OBJECTIVES:
We aimed to assess the outcomes of cardiogenic shock (CS) complicating acute coronary syndromes (ACS).BACKGROUND:
CS remains the leading cause of mortality in patients presenting with ACS despite advances in care.METHODS:
We studied 13,184 patients undergoing percutaneous coronary intervention (PCI) for all subtypes of ACS enrolled prospectively in a large multicentre Australian registry (Melbourne Interventional Group registry) from 2005 to 2013. All-cause mortality was obtained via linkage to the National Death Index. Patients were divided into those with and those without CS.RESULTS:
Compared to the non-CS group (n = 12,548, 95.2%), the CS group (n = 636, 4.8%) had a higher proportion of out-of-hospital cardiac arrest (OHCA) (31.1 vs. 2.2%) and ST-elevation myocardial infarction (STEMI) presentation (89 vs. 34%), both p < .01. Patients in the CS group had higher rates of in-hospital (40.4 vs. 1.2%) and 30-day (41 vs. 1.7%) mortality compared to the non-CS group. Long-term mortality over a median follow-up of 4.2 years was higher in the CS group (50.6 vs. 13.8%), p < .001. Trends of in-hospital and 30-day mortality rates of CS complicating ACS were relatively stable from 2005 to 2013. Predictors of long-term NDI-linked mortality within the CS group include severe left ventricular systolic dysfunction (HR 3.0), glomerular filtration rate (GFR) <30 (HR 2.56), GFR 30-59 (HR 1.94), OHCA (HR 1.46), diabetes (HR 1.44), and age (HR 1.02), all p < .05.CONCLUSIONS:
Rates of CS-related mortality complicating ACS have remained very high and steady over nearly a decade despite progress in STEMI systems of care, PCI techniques, and medical therapy.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Choque Cardiogênico
/
Mortalidade Hospitalar
/
Síndrome Coronariana Aguda
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Infarto do Miocárdio com Supradesnível do Segmento ST
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article