Document Detail

Cardiogenic shock at admission in patients with multivessel disease and acute myocardial infarction treated with percutaneous coronary intervention: related factors.
MedLine Citation:
PMID:  17303267     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Among patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI), those with multivessel disease have worse prognosis, mainly due to a higher frequency of cardiogenic shock (CS) at admission. The aim of this study was to identify clinical and angiographic characteristics of patients with STEMI, multivessel disease and CS at admission referred to primary PCI. METHODS: We studied 630 patients with STEMI treated with primary PCI within 12 h after symptoms onset. Multivessel disease was defined as the presence of >or=50% stenosis in >or=2 major epicardial arteries. Multivessel disease was documented in 276 patients (44%), these patients comprising the study population. Clinical, angiographic and procedural variables were compared between those with and without CS. A logistic regression analysis was performed to identify the independent predictors of CS among patients with multivessel disease. RESULTS: Among patients with multivessel disease, 45 (16%) had CS at admission. The independent predictors of CS in patients with multivessel disease were: STEMI anterior [OR 2.05; 95% CI 1.0 to 4.1; p=0.044], female gender [odds ratio (OR) 2.49; 95% confidence intervals (CI) 1.1 to 5.3; p=0.021], proximal culprit lesion [OR 3.8; 95% CI 1.7 to 8.5; p<0.001], and chronic occlusion of other coronary arteries [OR 4.48; 95% CI 2.1 to 9.1; p<0.001]. CONCLUSIONS: Among patients with STEMI and multivessel disease, CS is especially frequent in STEMI anterior, female gender, proximal culprit lesion, and chronic occlusion of other vessels.
César Conde-Vela; Raúl Moreno; Rosana Hernández; María J Pérez-Vizcayno; Fernando Alfonso; Javier Escaned; Manel Sabaté; Camino Bañuelos; Carlos Macaya
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Publication Detail:
Type:  Journal Article     Date:  2007-02-15
Journal Detail:
Title:  International journal of cardiology     Volume:  123     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2007-11-26     Completed Date:  2007-12-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  29-33     Citation Subset:  IM    
Division of Interventional Cardiology, Cardiovascular Institute, Hospital Clínico San Carlos, Madrid, Spain.
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MeSH Terms
Angioplasty, Transluminal, Percutaneous Coronary / methods*
Coronary Angiography
Coronary Stenosis / complications,  radiography,  therapy*
Follow-Up Studies
Myocardial Infarction / complications,  radiography,  therapy*
Patient Admission*
Prospective Studies
Risk Factors
Shock, Cardiogenic / epidemiology,  etiology*

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