Analysis of the mortality risk factors of mechanical circulatory support in patients with acute myocardial infarction and cardiogenic shock
10.3760/cma.j.cn112434-20240222-00053
- VernacularTitle:机械循环支持下急性心肌梗死合并心源性休克患者死亡的危险因素分析
- Author:
Ning ZHANG
1
;
Wenxian LIU
;
Yunpeng KANG
Author Information
1. 首都医科大学附属北京安贞医院心内科监护室，北京 100029
- Keywords:
Acute myocardial infarction;
Cardiogenic shock;
Mechanical circulatory support;
Risk factors
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2024;40(7):399-405
- CountryChina
- Language:Chinese
-
Abstract:
Objective:This was a retrospective study to analyze the risk factors for death in patients with acute myocardial infarction complicated with cardiogenic shock(AMICS) under mechanical circulatory support(MCS).Methods:This study included 234 patients with AMICS who were admitted to Anzhen Hospital in Beijing from January 2018 to January 2024.Among them, 79 cases died and 155 cases survived. 117 patients received MCS after percutaneous coronary intervention(PCI)(defined as delayed MCS treatment). Baseline and clinical data of patients in the death group and the survival group were compared to analyze the potential risk factors that may affect death.Results:Statistical analysis showed that higher white blood cell count( OR=1.017, P=0.003, 95% CI: 1.005-1.028), higher arterial lactate level( OR=2.021, P<0.001, 95% CI: 1.463-2.794), three-vessel coronary artery disease( OR=3.179, P<0.001, 95% CI: 1.679-6.019), delayed MCS treatment( OR=4.691, P=0.001, 95% CI: 1.955-11.258), MCS assisted aortic balloon counterpulsation alone(IABP)( OR=4.140, P<0.001, 95% CI: 2.230-7.786)were independent risk factors for in-hospital mortality in AMICS patients under mechanical circulatory support. The arterial lactate level were shown to be predictive of death in patients with AMICS assisted by MCS, and an area under the receiving operating characteristic curve of 0.719, P<0.001, 95% CI: 0.667-0.770, the maximum Youden index was 0.395, and the cutoff value of 5.05 mmol/L. Conclusion:Higher number of white blood cells, high arterial lactate level(>5.05 mmol/L), three-vessel coronary artery disease, delayed MCS treatment, and McS-assisted aortic balloon counterpulsation alone were independent risk factors for mortality in patients with McS-assisted AMICS.
