| Time of onset and outcome of cardiogenic shock in acute coronary syndromes. | |
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MedLine Citation:
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PMID: 19001930 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND AND METHODS: The aim of our study was to evaluate the incidence, timing of the onset and outcome of cardiogenic shock in a group of 865 patients with acute coronary syndromes who were consecutively admitted to our Intensive Cardiac Care Unit (ICCU) from January 2004 to December 2005. RESULTS: Eighty-seven patients had cardiogenic shock; 65 (74.7%, 65/87) on ICCU admission ('early' cardiogenic shock) and 22 (25.3%, 22/87) during ICCU stay ('delayed' cardiogenic shock). Left ventricular systolic dysfunction was the cause of cardiogenic shock in 90.7% of patients (59/65) with early cardiogenic shock and in 50% of patients (11/22) with delayed cardiogenic shock (P < 0.001). Patients with early shock exhibited higher serum levels of troponin I (P = 0.029), higher serum levels of glucose on admission (P = 0.009), lower ejection fraction (=0.003), whereas latency (time from symptoms onset to percutaneous coronary intervention) was higher in patients with delayed shock (P = 0.032). Intra-ICCU mortality was comparable in the two subgroups of patients. At multivariable logistic regression analysis, age, percutaneous coronary intervention failure, glycemia on admission and the development of mechanical complications were independent predictors of intra-ICCU mortality. CONCLUSION: Primary percutaneous coronary intervention has reduced the number of patients who develop cardiogenic shock after ICCU admission. According to our results, cardiogenic shock in patients with ST-elevation myocardial infarction developed early after symptoms' onset and, despite optimal treatment, mortality in these patients remains high (about 50%). Delayed cardiogenic shock is mainly due to mechanical complications as well as due to PCI complications. |
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Authors:
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Serafina Valente; Chiara Lazzeri; Marco Chiostri; Andrea Sori; Cristina Giglioli; Claudia Salvadori; Gian Franco Gensini |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of cardiovascular medicine (Hagerstown, Md.) Volume: 9 ISSN: 1558-2027 ISO Abbreviation: J Cardiovasc Med (Hagerstown) Publication Date: 2008 Dec |
Date Detail:
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Created Date: 2008-11-12 Completed Date: 2009-02-06 Revised Date: 2009-05-28 |
Medline Journal Info:
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Nlm Unique ID: 101259752 Medline TA: J Cardiovasc Med (Hagerstown) Country: United States |
Other Details:
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Languages: eng Pagination: 1235-40 Citation Subset: IM |
Affiliation:
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Intensive Cardiac Care Unit, Heart and Vessel Department, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy. seravalente@hotmail.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acute Coronary Syndrome
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complications*,
physiopathology Aged Blood Glucose / analysis Coronary Care Units Female Humans Male Shock, Cardiogenic / etiology*, mortality Stroke Volume Time Factors Troponin I / blood Ventricular Dysfunction, Left / complications |
| Chemical | |
Reg. No./Substance:
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0/Blood Glucose; 0/Troponin I |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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