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We aimed to assess the predictive factors of mortality in the patients with acute myocardial infarction (AMI) complicated by cardiogenic shock (CS).
Between May 2007 and January 2012, 1,020 AMI patients (69.1±12.4 years, 629 males) who complicated by cardiogenic shock were enrolled. 498 of them survived without major adverse cardiac events (MACEs) (Group I, 66.3±12.4 years, 350 males) and 522 with MACEs (Group II, 72.0±11.7 years, 279 males) during 12 months follow-up.
Patients in Group II were more likely to be older and female gender (29.7% vs. 46.6%, p<0.0001). Group II had more history of diabetes mellitus (DM) and hypertension, lower left ventricular ejection fraction (LVEF), higher regional wall motion scores (RWMS), higher serum glucose, creatinine, high-sensitivity C-reactive protein (hsCRP), N-terminal pro-brain natriuretic peptide (NT-proBNP), and lower total cholesterol, triglyceride, and low density lipoprotein (LDL) cholesterol. Group II also had lower incidence of history of smoking and dyslipidemia (11.2% vs. 5.4%, p=0.001), and family history of coronary artery disease. In coronary angiographic findings, left main (2.4% vs. 10.4%, p<0.0001) and left anterior descending (LAD) (35.1% vs. 43.2%, p=0.008) were more likely to be infarct-related artery (IRA) in Group II. Group II had more patients with pre-TIMI flow 0 (60.0% vs. 69.8%, p=0.001) and intra-aortic balloon pump (IABP) use (29.7% vs. 46.6%, p<0.0001). In univariate analysis, old age and female gender, DM, non-smoker, low LVEF, high RWMS, high serum glucose, creatinine, hsCRP, and NT-proBNP, low total cholesterol, triglyceride, and LDL cholesterol at admission were the predictors for 12 months MACEs in patients with AMI complicated by CS. Left main and LAD as IRA, pre-TIMI flow 0, and insertion of IABP were also the predictors. In multivariate logistic regression analysis, higher NT-proBNP (OR=1.602, 95% CI=1.295–1.981, p<0.0001) at admission was an independent predictor for 12 months MACEs in patients with AMI complicated by CS.
High NT-proBNP at admission was an independent predictor of 12 months MACEs in patients with AMI complicated by CS.
Poster Sessions, Expo North
Saturday, March 09, 2013, 10:00 a.m.-10:45 a.m.
Session Title: MI Complications: Shock, Arrest and Cardiac Rupture
Abstract Category: 1. Acute Coronary Syndromes: Clinical
Presentation Number: 1126-179
- 2013 American College of Cardiology Foundation