Risk factors for in-hospital mortality in patients with acute myocardial infarction complicated with cardiogenic shock after primary percutaneous coronary intervention
10.3760/cma.j.issn.1671-0282.2019.05.017
- VernacularTitle:急性心肌梗死合并心源性休克患者急诊冠脉介入术后院内死亡危险因素分析
- Author:
Xiaohong WEI
1
;
Wenxian LIU
;
Liying CHEN
;
Kun YANG
Author Information
1. 首都医科大学附属北京安贞医院心内科重症监护室
- Keywords:
Acute myocardial infarction;
Cardiogenic shock;
Primary percutaneous coronary intervention;
In-hospital mortality;
Risk factors
- From:
Chinese Journal of Emergency Medicine
2019;28(5):619-624
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe the risk factors of in-hospital mortality in patients with acute myocardial infarction complicated with cardiogenic shock after primary percutaneous coronary intervention (PCI).Methods Totally 111 cases of acute myocardial infarction complicated with cardiogenic shock received acute PCI from 2009 to 2015 in Beijing Anzhen Hospital were enrolled.The cases were divided into the in-hospital death group (31 cases) and the in-hospital survival group (80 cases).The general information,clinical indicators,range of myocardial infarction,coronary lesions and management,complications,drug treatment and equipment assistance of the two groups were compared,and logistic regression analysis was used to analyze the risk factors of in-hospital mortality.Results The proportions of age ≥ 75 years,hyperlipidemia,serum creatinine ＞ 110 μmol/L,LVEF ＜ 40％,anterior myocardial infarction,three-vessel lesions of coronary artery,post-PCI TIMI flow grade ＜3,acute liver injury and acute kidney injury in the in-hospital death group were significantly higher than those in the in-hospital survival group (P ＜ 0.05).The proportion of IABP used in the in-hospital death group was significantly higher than that in the in-hospital survival group (P ＜ 0.05).There were no significant differences in the distribution of culprit lesion and the treatment of stenoses in nonculprit arteries between the two groups (P ＞ 0.05).Multivariate logistic regression analysis showed that age ≥ 75 years,threevessel coronary lesions,post-PCI TIMI flow grade ＜3 and acute renal injury were independent risk factors for hospital mortality (P ＜ 0.05).Conclusions Age ≥ 75 years,three-vessel lesions of coronary artery,post-PCI TIMI flow grade ＜3 and acute kidney injury were independent risk factors of in-hospital death in patients with acute myocardial infarction complicated with cardiogenic shock after primary PCI.
