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Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
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Predictors of outcome after percutaneous treatment for cardiogenic shock

A G C Sutton1, P Finn, J A Hall

  • 1Cardiothoracic Division, The James Cook University Hospital, Marton Road, Middlesbrough TS4 3BW, UK. Andrew.Sutton@stees.nhs.uk

Heart (British Cardiac Society)
|February 16, 2005
PubMed

Insights

Predictors of outcome after percutaneous coronary intervention (PCI) for cardiogenic shock complicating acute myocardial infarction were identified. Older age, previous myocardial infarction, and failed thrombolysis independently predicted in-hospital death, guiding patient selection for PCI.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Critical Care Medicine

Background:

  • Cardiogenic shock complicating acute myocardial infarction (AMI) carries a high mortality rate.
  • Percutaneous coronary intervention (PCI) is a strategy to restore coronary blood flow in AMI.
  • Predicting outcomes in patients with cardiogenic shock undergoing PCI is crucial for treatment planning.

Purpose of the Study:

  • To identify predictors of outcome in patients with cardiogenic shock complicating AMI who undergo PCI.
  • To assess the effectiveness of emergency PCI in reducing mortality in this high-risk group.

Main Methods:

  • Retrospective analysis of 113 patients with cardiogenic shock complicating AMI undergoing emergency coronary angiography and PCI.
  • Multivariate logistic regression analysis to determine independent predictors of in-hospital mortality.

Main Results:

  • In-hospital mortality was 51%.
  • Previous myocardial infarction, age over 70 years, and failed thrombolysis were independent predictors of in-hospital death.
  • Emergency PCI reduced mortality from an expected 80% to approximately 50%.

Conclusions:

  • Approximately 50% of patients with cardiogenic shock undergoing urgent PCI survive hospitalization, with good outcomes at six months.
  • Clinical factors can identify patients most likely to benefit from urgent PCI.
  • Alternative strategies are needed to improve outcomes for patients with poor prognoses.
Abstract

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