| Predictors of outcome after percutaneous treatment for cardiogenic shock. | |
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MedLine Citation:
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PMID: 15710715 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: To determine predictors of outcome after percutaneous coronary intervention (PCI) in patients with cardiogenic shock complicating acute myocardial infarction. METHODS: Retrospective analysis of a cohort of 113 patients undergoing emergency coronary angiography and attempted PCI for cardiogenic shock complicating acute myocardial infarction in a regional cardiothoracic unit. RESULTS: In-hospital mortality was 51% (58 patients). Adverse outcome was associated with previous myocardial infarction, age over 70 years, cardiogenic shock complicating failure to respond to thrombolytic treatment (failed thrombolysis), and multivessel coronary artery disease. Multivariate logistic regression analysis showed that the first three factors were independent predictors of in-hospital death with odds ratios of 5.21 (95% confidence interval (CI) 1.85 to 14.69), 4.02 (95% CI 1.14 to 14.12), and 3.78 (95% CI 1.43 to 9.96), respectively. CONCLUSION: About 50% of patients with cardiogenic shock undergoing a strategy of urgent coronary angiography and PCI survive to hospital discharge. Survivors do well in the subsequent six months. Emergency PCI for cardiogenic shock reduces mortality from an expected 80% to about 50%. Clinical features can help determine which patients are most likely to gain from urgent coronary angiography and attempted PCI. Alternative strategies are needed to improve the outcome of patients who fare badly. |
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Authors:
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A G C Sutton; P Finn; J A Hall; A A Harcombe; R A Wright; M A de Belder |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Heart (British Cardiac Society) Volume: 91 ISSN: 1468-201X ISO Abbreviation: Heart Publication Date: 2005 Mar |
Date Detail:
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Created Date: 2005-02-15 Completed Date: 2005-03-07 Revised Date: 2009-11-18 |
Medline Journal Info:
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Nlm Unique ID: 9602087 Medline TA: Heart Country: England |
Other Details:
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Languages: eng Pagination: 339-44 Citation Subset: AIM; IM |
Affiliation:
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Cardiothoracic Division, The James Cook University Hospital, Marton Road, Middlesbrough TS4 3BW, UK. Andrew.Sutton@stees.nhs.uk |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Age Factors Aged Angioplasty, Transluminal, Percutaneous Coronary / methods* Coronary Angiography / methods Coronary Disease / complications Female Humans Male Middle Aged Recurrence Regression Analysis Retrospective Studies Risk Factors Shock, Cardiogenic / complications, mortality, therapy* Survival Analysis Thrombolytic Therapy / methods Time Factors Treatment Outcome |
| Comments/Corrections | |
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