| Revascularization, stenting, and outcomes of patients with acute myocardial infarction complicated by cardiogenic shock. | |
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MedLine Citation:
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PMID: 12372570 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Randomized clinical trials have demonstrated a reduction in mortality with early revascularization of patients with acute myocardial infarction (AMI) complicated by cardiogenic shock, and recent single-center studies have particularly suggested further benefit for coronary stenting. The purpose of this study was to examine the use of revascularization and coronary stenting for patients with shock from a multicenter, international perspective. Patients with AMI complicated by cardiogenic shock (n = 583) who enrolled between April 1999 and June 2001 were prospectively identified from the large, multinational, observational Global Registry of Acute Coronary Events. We examined the use of coronary reperfusion strategies, adjunctive therapy, and hospital mortality in this group of patients. Cardiac catheterization (52%) and revascularization (43%) were performed in approximately half of the cardiogenic shock patients. Elderly patients (age >/=75 years) comprised 40% of the shock cohort. Regional differences were seen in the use of revascularization, adjunctive medical therapy, and type of revascularization used (coronary stenting). Total hospital mortality was 59%, but case fatality rates ranged from 35% for patients who underwent coronary stenting to 74% for patients who did not undergo any cardiac catheterization. Percutaneous coronary intervention with coronary stenting was the most powerful predictor of hospital survival (odds ratio 3.99, 95% confidence interval 2.41 to 6.62). Thus, cardiogenic shock continues to be a devastating complication of AMI, and relative underuse of a revascularization strategy may be related to the large proportion of elderly patients in this population. In this multinational registry study, coronary stenting was the most powerful independent predictor of hospital survival. |
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Authors:
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Harold L Dauerman; Robert J Goldberg; Kami White; Joel M Gore; Immad Sadiq; Enrique Gurfinkel; Andrzej Budaj; Esteban Lopez de Sa; Jose Lopez-Sendon; |
Publication Detail:
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Type: Comparative Study; Evaluation Studies; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The American journal of cardiology Volume: 90 ISSN: 0002-9149 ISO Abbreviation: Am. J. Cardiol. Publication Date: 2002 Oct |
Date Detail:
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Created Date: 2002-10-09 Completed Date: 2002-11-08 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 838-42 Citation Subset: AIM; IM |
Affiliation:
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University of Vermont College of Medicine, Fletcher Allen Health Care, Burlington, Vermont 05401, USA. harold.dauerman@vtmednet.org |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Cohort Studies Female Hospital Mortality Humans Male Middle Aged Myocardial Infarction / mortality, therapy* Myocardial Revascularization* Outcome and Process Assessment (Health Care) Prospective Studies Registries Shock, Cardiogenic / mortality, therapy* Stents* Survival Rate |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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