Document Detail


Predictors of outcome after percutaneous treatment for cardiogenic shock.
MedLine Citation:
PMID:  15710715     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Journal Article    
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  91     ISSN:  1468-201X     ISO Abbreviation:  Heart     Publication Date:  2005 Mar 
Date Detail:
Created Date:  2005-02-15     Completed Date:  2005-03-07     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  England    
Other Details:
Languages:  eng     Pagination:  339-44     Citation Subset:  AIM; IM    
Affiliation:
Cardiothoracic Division, The James Cook University Hospital, Marton Road, Middlesbrough TS4 3BW, UK. Andrew.Sutton@stees.nhs.uk
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MeSH Terms
Descriptor/Qualifier:
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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