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Biventricular dysfunction predicts mortality in ST elevation myocardial infarction patients with cardiogenic shock

Angga Dwi Prasetyo1, Hendry Purnasidha Bagaswoto2, Firandi Saputra1

  • 1Department of Cardiology and Vascular Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Jalan Farmako Sekip Utara, Yogyakarta, 55281, Indonesia.

The Egyptian Heart Journal : (EHJ) : Official Bulletin of the Egyptian Society of Cardiology
|January 8, 2025
PubMed

Insights

Biventricular dysfunction significantly increases in-hospital mortality risk in ST-elevation myocardial infarction (STEMI) patients experiencing cardiogenic shock. Other mortality predictors include renal failure and vasopressor use.

Area of Science:

  • Cardiology
  • Intensive Care Medicine
  • Clinical Research

Background:

  • Mortality in cardiogenic shock due to ST-elevation myocardial infarction (STEMI) remains high despite reperfusion therapy.
  • Ventricular systolic dysfunction is a primary cause of cardiogenic shock in STEMI.
  • While left and right ventricular dysfunction have been studied, the predictive value of biventricular dysfunction for mortality is unclear.

Purpose of the Study:

  • To evaluate the mortality predictive value of biventricular systolic dysfunction in STEMI patients with cardiogenic shock.
  • To identify key predictors of in-hospital mortality in this patient population.

Main Methods:

  • Retrospective cohort study using the Sardjito Cardiovascular Intensive Care (SCIENCE) registry.
  • Data collected from November 2021 to September 2023 at Dr. Sardjito General Hospital.
  • Multivariate logistic regression analysis to assess predictors of in-hospital mortality.

Main Results:

  • Biventricular dysfunction (BVD) significantly increases the risk of in-hospital mortality (OR, 1.771; p=0.016).
  • Other significant mortality predictors include renal failure (OR, 5.122; p<0.001) and inotropic/vasopressor use (OR, 6.876; p<0.001).
  • Percutaneous coronary intervention (PCI) was associated with reduced mortality (OR, 0.493; p=0.044).

Conclusions:

  • Biventricular dysfunction is a significant independent predictor of in-hospital mortality in STEMI patients with cardiogenic shock.
  • Renal failure and the need for inotropic or vasopressor support are critical factors influencing mortality.
  • PCI may play a protective role in reducing mortality in this cohort.
Abstract

Keywords:
Cardiogenic shockEchocardiographyMortalityST elevated myocardial infarction

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