Predictors of Outcome After Percutaneous Treatment for Cardiogenic Shock

Overview

Journal Heart

Date 2005 Feb 16

PMID 15710715

Citations 20

Authors

A G C Sutton

P Finn

J A Hall

A A Harcombe

R A Wright

M A de Belder

Affiliations

Soon will be listed here.

Abstract

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.

Citing Articles

Cardiac Failure and Cardiogenic Shock: Insights Into Pathophysiology, Classification, and Hemodynamic Assessment.

Siopi S, Antonitsis P, Karapanagiotidis G, Tagarakis G, Voucharas C, Anastasiadis K Cureus. 2024; 16(10):e72106.

PMID: 39575019 PMC: 11581444. DOI: 10.7759/cureus.72106.

Predictors of short-term mortality in cardiogenic shock: insights from an Egyptian multicenter registry.

Taha H, Gohar A, Ammar W, Alhossary H, Adel A, Diab R Egypt Heart J. 2024; 76(1):94.

PMID: 39060876 PMC: 11282039. DOI: 10.1186/s43044-024-00525-y.

The Impact of Sex on Cardiogenic Shock Outcomes Following ST Elevation Myocardial Infarction.

Arnold J, Perl L, Assali A, Codner P, Greenberg G, Samara A J Clin Med. 2023; 12(19).

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Schmitt A, Weidner K, Rusnak J, Ruka M, Egner-Walter S, Mashayekhi K J Geriatr Cardiol. 2023; 20(8):555-566.

PMID: 37675262 PMC: 10477585. DOI: 10.26599/1671-5411.2023.08.003.

Age as a predictor of clinical outcomes and determinant of therapeutic measures for emergency medical services treated cardiogenic shock.

Xiao X, Bloom J, Andrew E, Dawson L, Nehme Z, Stephenson M J Geriatr Cardiol. 2023; 20(1):1-10.

PMID: 36875161 PMC: 9975487. DOI: 10.26599/1671-5411.2023.01.004.

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