CLINICAL OUTCOMES OF PATIENTS WITH CARDIOGENIC SHOCK COMPLICATING ACUTE MYOCARDIAL INFARCTION: THE GULF-CARDIOGENIC...

Area of Science:

• Cardiology
• Critical Care Medicine
• Clinical Research

Background:

• Limited data exists on acute myocardial infarction (MI) complicated by cardiogenic shock (AMI-CS) within the Gulf region.
• This study aimed to fill this knowledge gap by analyzing patient data from the Gulf-Cardiogenic Shock registry.

Purpose of the Study:

• To investigate the incidence, characteristics, and mortality of AMI-CS patients in the Gulf region.
• To identify factors associated with in-hospital mortality in this patient population.
• To evaluate the impact of interventions like hemodynamic monitoring, revascularization, and mechanical circulatory support on survival.

Main Methods:

• The Gulf-Cardiogenic Shock registry collected data on 1,513 patients diagnosed with AMI-CS between January 2020 and December 2022.
• Analysis included patient demographics, clinical presentation, interventions, and short-term (in-hospital and 12-month) mortality.
• Statistical methods were used to identify factors associated with hospital mortality, including odds ratios (OR) and confidence intervals (CI).

Main Results:

• The incidence of AMI-CS was 4.1%. The median age was 60 years, with ST-elevation MI being the most common presentation (73.83%).
• In-hospital mortality was high at 45.5%. Patients in Society for Cardiovascular Angiography and Interventions (SCAI) shock classification stages D and E constituted 68.94%.
• Key mortality predictors included previous coronary artery bypass graft, cerebrovascular accident, chronic kidney disease, cardiac arrest, advanced SCAI stage, prolonged QRS, right ventricular dysfunction, and ventricular septal rupture. 12-month survival was 51.49%.

Conclusions:

• AMI-CS poses a significant health burden in the Gulf region, characterized by high in-hospital mortality.
• Several clinical factors, including advanced shock severity and specific comorbidities, are strongly associated with increased hospital mortality.
• Despite aggressive management with invasive monitoring, revascularization, and mechanical support, 12-month survival remains suboptimal, indicating a need for enhanced therapeutic strategies.