Factors of prognosis of patients with acute myocardial infarction complicated with cardiogenic shock undergoing primary percutaneous coronary intervention under the support of mechanical devices
10.3969/j.issn.1004-8812.2024.04.003
- VernacularTitle:急性心肌梗死合并心原性休克患者器械辅助支持下直接经皮冠状动脉介入治疗预后不良的因素分析
- Author:
Ming-Hua LUO
1
;
Yu-Shan CHEN
;
He WANG
;
Huai-Min GUAN
;
Jin-Hong XIE
;
Cheng-Jie QIU
;
Yong-Hua ZONG
;
Sha-Sha SHANG
;
Yun-Wei WANG
Author Information
1. 河南中医药大学第一附属医院心脏中心/国家区域(中医)心血管诊疗中心,河南郑州 450000
- Keywords:
Acute myocardial infarction;
Cardiogenic shock;
Prognosis;
Primary percutaneous coronary intervention;
Myocardial enzymes;
Extracorporeal membrane oxygenation;
Intra-aortic balloon pump
- From:
Chinese Journal of Interventional Cardiology
2024;32(4):197-202
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the factors influencing prognosis in patients with acute myocardial infarction complicated with cardiogenic shock undergoing primary percutaneous coronary intervention(PPCI).Methods Patients with acute myocardial infarction complicated with cardiogenic shock who underwent PPCI at our hospital between January 2015 and December 2019 were enrolled.Clinical baseline characteristics,coronary angiography and PCI-related parameters,and mechanical support information were collected.The patients were followed up for one year and divided into survival and death groups based on their survival status within one year.Differences in various factors between the two groups were compared.Results A total of 40 patients were enrolled,including 26 in the survival group and 14 in the death group.There were no differences in baseline data,diagnosis,risk factors,and comorbidities between the two groups.The survival group had a lower heart rate and higher blood pressure trend at admission compared to the death group.Myocardial enzymes were significantly lower in the survival group compared to the death group(median CK peak:496.00(198.25,2 830.00)U/L vs.3 040.00(405.75,5 626.53)U/L,P=0.003;median CK-MB peak:52.65(31.75,219.50)U/L vs.306.00(27.25,489.63)U/L,P=0.006).When comparing coronary angiography and PCI-related indicators between the two groups,the survival group had a higher rate of complete revascularization compared to the control group(53.85％vs.21.43％,P=0.048).The survival group had a higher proportion of extracorporeal membrane oxygenation(ECMO)combined with intra-aortic balloon pump(IABP)support compared to the control group[38.46％vs.7.14％,P=0.034].Conclusions Survival in patients with acute myocardial infarction complicated with cardiogenic shock undergoing PPCI is associated with lower level of myocardial enzymes,ECMO combined with IABP support and complete revascularization.
