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Immediate in-hospital outcomes after percutaneous revascularization of acute myocardial infarction complicated by cardiogenic shock

BACKGROUND: Cardiogenic shock (CS) is a life-threatening complication of acute myocardial infarction with high morbidity and mortality rates. Primary percutaneous coronary intervention (PCI) has been shown to improve outcomes in patients with CS. AIM: To investigate the immediate mortality rates in...

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Autores principales: Solangi, Bashir Ahmed, Shah, Jehangir Ali, Kumar, Rajesh, Batra, Mahesh Kumar, Ali, Gulzar, Butt, Muhammad Hassan, Nisar, Ambreen, Qamar, Nadeem, Saghir, Tahir, Sial, Jawaid Akbar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10600783/
https://www.ncbi.nlm.nih.gov/pubmed/37900262
http://dx.doi.org/10.4330/wjc.v15.i9.439
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author Solangi, Bashir Ahmed
Shah, Jehangir Ali
Kumar, Rajesh
Batra, Mahesh Kumar
Ali, Gulzar
Butt, Muhammad Hassan
Nisar, Ambreen
Qamar, Nadeem
Saghir, Tahir
Sial, Jawaid Akbar
author_facet Solangi, Bashir Ahmed
Shah, Jehangir Ali
Kumar, Rajesh
Batra, Mahesh Kumar
Ali, Gulzar
Butt, Muhammad Hassan
Nisar, Ambreen
Qamar, Nadeem
Saghir, Tahir
Sial, Jawaid Akbar
author_sort Solangi, Bashir Ahmed
collection PubMed
description BACKGROUND: Cardiogenic shock (CS) is a life-threatening complication of acute myocardial infarction with high morbidity and mortality rates. Primary percutaneous coronary intervention (PCI) has been shown to improve outcomes in patients with CS. AIM: To investigate the immediate mortality rates in patients with CS undergoing primary PCI and identify mortality predictors. METHODS: We conducted a retrospective analysis of 305 patients with CS who underwent primary PCI at the National Institute of Cardiovascular Diseases, Karachi, Pakistan, between January 2018 and December 2022. The primary outcome was immediate mortality, defined as mortality within index hospitalization. Univariate and multivariate logistic regression analyses were performed to identify predictors of immediate mortality. RESULTS: In a sample of 305 patients with 72.8% male patients and a mean age of 58.1 ± 11.8 years, the immediate mortality rate was found to be 54.8% (167). Multivariable analysis identified Killip class IV at presentation [odds ratio (OR): 2.0; 95% confidence interval (CI): 1.2-3.4; P = 0.008], Multivessel disease (OR: 3.5; 95%CI: 1.8-6.9; P < 0.001), and high thrombus burden (OR: 2.6; 95%CI: 1.4-4.9; P = 0.003) as independent predictors of immediate mortality. CONCLUSION: Immediate mortality rate in patients with CS undergoing primary PCI remains high despite advances in treatment strategies. Killip class IV at presentation, multivessel disease, and high thrombus burden (grade ≥ 4) were identified as independent predictors of immediate mortality. These findings underscore the need for aggressive management and close monitoring of patients with CS undergoing primary PCI, particularly in those with these high-risk characteristics.
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spelling pubmed-106007832023-10-27 Immediate in-hospital outcomes after percutaneous revascularization of acute myocardial infarction complicated by cardiogenic shock Solangi, Bashir Ahmed Shah, Jehangir Ali Kumar, Rajesh Batra, Mahesh Kumar Ali, Gulzar Butt, Muhammad Hassan Nisar, Ambreen Qamar, Nadeem Saghir, Tahir Sial, Jawaid Akbar World J Cardiol Retrospective Study BACKGROUND: Cardiogenic shock (CS) is a life-threatening complication of acute myocardial infarction with high morbidity and mortality rates. Primary percutaneous coronary intervention (PCI) has been shown to improve outcomes in patients with CS. AIM: To investigate the immediate mortality rates in patients with CS undergoing primary PCI and identify mortality predictors. METHODS: We conducted a retrospective analysis of 305 patients with CS who underwent primary PCI at the National Institute of Cardiovascular Diseases, Karachi, Pakistan, between January 2018 and December 2022. The primary outcome was immediate mortality, defined as mortality within index hospitalization. Univariate and multivariate logistic regression analyses were performed to identify predictors of immediate mortality. RESULTS: In a sample of 305 patients with 72.8% male patients and a mean age of 58.1 ± 11.8 years, the immediate mortality rate was found to be 54.8% (167). Multivariable analysis identified Killip class IV at presentation [odds ratio (OR): 2.0; 95% confidence interval (CI): 1.2-3.4; P = 0.008], Multivessel disease (OR: 3.5; 95%CI: 1.8-6.9; P < 0.001), and high thrombus burden (OR: 2.6; 95%CI: 1.4-4.9; P = 0.003) as independent predictors of immediate mortality. CONCLUSION: Immediate mortality rate in patients with CS undergoing primary PCI remains high despite advances in treatment strategies. Killip class IV at presentation, multivessel disease, and high thrombus burden (grade ≥ 4) were identified as independent predictors of immediate mortality. These findings underscore the need for aggressive management and close monitoring of patients with CS undergoing primary PCI, particularly in those with these high-risk characteristics. Baishideng Publishing Group Inc 2023-09-26 2023-09-26 /pmc/articles/PMC10600783/ /pubmed/37900262 http://dx.doi.org/10.4330/wjc.v15.i9.439 Text en ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved. https://creativecommons.org/licenses/by-nc/4.0/This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.
spellingShingle Retrospective Study
Solangi, Bashir Ahmed
Shah, Jehangir Ali
Kumar, Rajesh
Batra, Mahesh Kumar
Ali, Gulzar
Butt, Muhammad Hassan
Nisar, Ambreen
Qamar, Nadeem
Saghir, Tahir
Sial, Jawaid Akbar
Immediate in-hospital outcomes after percutaneous revascularization of acute myocardial infarction complicated by cardiogenic shock
title Immediate in-hospital outcomes after percutaneous revascularization of acute myocardial infarction complicated by cardiogenic shock
title_full Immediate in-hospital outcomes after percutaneous revascularization of acute myocardial infarction complicated by cardiogenic shock
title_fullStr Immediate in-hospital outcomes after percutaneous revascularization of acute myocardial infarction complicated by cardiogenic shock
title_full_unstemmed Immediate in-hospital outcomes after percutaneous revascularization of acute myocardial infarction complicated by cardiogenic shock
title_short Immediate in-hospital outcomes after percutaneous revascularization of acute myocardial infarction complicated by cardiogenic shock
title_sort immediate in-hospital outcomes after percutaneous revascularization of acute myocardial infarction complicated by cardiogenic shock
topic Retrospective Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10600783/
https://www.ncbi.nlm.nih.gov/pubmed/37900262
http://dx.doi.org/10.4330/wjc.v15.i9.439
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