Predictors of short term mortality in patients with acute ST-elevation myocardial infarction complicated by cardiogenic shock
10.3760/cma.j.issn.0253-3758.2010.08.005
- VernacularTitle:急性心肌梗死合并心原性休克死亡危险因素分析
- Author:
Yao LIU
1
;
Yan-Min YANG
;
Jun ZHU
;
Hui-Qiong TAN
;
Yan LIANG
;
Li-Sheng LIU
;
Ying LI
Author Information
1. 中国医学科学院,北京协和医学院,阜外心血管病医院
- Keywords:
Myocardial infarction;
Shock,cardiogenic;
Mortality;
Prognosis
- From:
Chinese Journal of Cardiology
2010;38(8):695-701
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the indepedent risk factors associated with short term mortality in patients with ST-segment elevation acute myocardial infarction(STEMI)complicated by cardiogenic shock (CS). Methods We analyzed data from Chinese patients with ST-segment elevation myocardial infarction (STEMI)and cardiogenic shock enrolled in the CREATE trial. Predictors of 30-day mortality were identified by univariate and multivariate logistic regression analysis using baseline and procedural variables. Results The overall 30-day mortality of STEMI complicated by CS among the 517 patients[(68.5±10.3)years and 57. 6% male]was 62.3%. Logistic regression analysis showed that the independent risk factors of death included age(OR = 1.46,95% CI: 1.18 - 1.81), anterior infarction(OR = 2.01,95% CI 1.29 - 3.11),admission glucose level ＞ 7. 8 mmol/L(OR = 2. 17,95% CI: 1.26 - 3.73), serum sodium concentration ＜130 mmol/L(OR =2. 21,95% CI:1. 21 -4. 04), left ventricular ejection fraction(LVEF)＜40% or sever left ventricular dysfunction(LVD)(OR = 3.78,95% CI: 2. 28 - 6. 27), no emergency revascularization (OR = 3.53, 95% CI: 1.20 - 10. 41)and diuretics use(OR = 1.90,95% CI: 1.21 - 2. 97). Analysis using baseline clinical variables showed that the first five risk factors mentioned above were also the baseline risk factors fro death. The receiver operating characteristic curve for predicting the death of the two models was 0.81(95%CI:0. 77 -0.86)and 0. 80(95%CI:0. 75 -0.84), respectively. Conclusion The 30-day mortality of patients with STEMI complicated by CS was over 60%. Age, anterior infarction, admission glucose level ＞7.8 mmol/L, serum sodium concentration ＜ 130 mmol/L, left ventricular ejection fraction (LVEF)＜40% and no emergency revascularization were independent risk factors associated with 30-day mortality.
