Outcome after primary percutaneous coronary intervention for ST-segment-elevation myocardial infarction complicated by cardiogenic shock.
J Cardiol
; 84(3): 189-194, 2024 Sep.
Article
em En
| MEDLINE
| ID: mdl-38373539
ABSTRACT
BACKGROUND:
Primary percutaneous coronary intervention (PCI) for ST-segment-elevation myocardial infarction (STEMI) complicated by cardiogenic shock (CS) may reduce the risk of subsequent cardiovascular events but remains challenging. The study aim was to evaluate the clinical characteristics and long-term outcomes of patients undergoing primary PCI for STEMI with CS.METHODS:
We conducted an observational cohort study of patients with STEMI who underwent primary PCI between April 2004 and December 2017 at Juntendo University Shizuoka Hospital. The primary outcome was cardiovascular death (CVD) during the median 3-year follow-up. We performed a landmark analysis for the incidence of CVD from 0â¯day to 1â¯year and from 1 to 10â¯years.RESULTS:
Among the 1758 STEMI patients in the cohort, 212 (12.1â¯%) patients with CS showed significantly higher 30-day CVD rate on admission than those without (26.4â¯% vs 2.9â¯%). Landmark Kaplan-Meier analysis showed that CVD from day 0 to year 1 was significantly higher in the patients with CS (log-rank pâ¯<â¯0.0001). Multivariate Cox regression analysis showed that CS was significantly associated with higher cardiovascular mortality (adjusted hazard ratio, 11.8; 95%confidence intervals, 7.78-18.1; pâ¯<â¯0.0001), but the mortality rates from 1 to 10â¯years were comparable (log-rank pâ¯=â¯0.68).CONCLUSION:
The cardiovascular 1-year mortality rate for patients with STEMI was higher for those with CS on admission than without, but the mortality rates of >1â¯year were comparable. Surviving the early phase is essential for patients with STEMI and CS to improve long-term outcomes.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Choque Cardiogênico
/
Intervenção Coronária Percutânea
/
Infarto do Miocárdio com Supradesnível do Segmento ST
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article