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Outcomes Associated with Respiratory Failure for Patients with Cardiogenic Shock and Acute Myocardial Infarction: A Substudy of the CULPRIT-SHOCK Trial
Background: Little is known about clinical outcomes of patients with acute myocardial infraction (AMI) complicated by cardiogenic shock (CS) requiring mechanical ventilation (MV). The aim of this study was to identify the characteristics, risk factors, and outcomes associated with the provision of M...
Autores principales: | , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7141492/ https://www.ncbi.nlm.nih.gov/pubmed/32245139 http://dx.doi.org/10.3390/jcm9030860 |
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author | Rubini Giménez, Maria Miller, P. Elliott Alviar, Carlos L. van Diepen, Sean Granger, Christopher B. Montalescot, Gilles Windecker, Stephan Maier, Lars Serpytis, Pranas Serpytis, Rokas Oldroyd, Keith G. Noc, Marko Fuernau, Georg Huber, Kurt Sandri, Marcus de Waha-Thiele, Suzanne Schneider, Steffen Ouarrak, Taoufik Zeymer, Uwe Desch, Steffen Thiele, Holger |
author_facet | Rubini Giménez, Maria Miller, P. Elliott Alviar, Carlos L. van Diepen, Sean Granger, Christopher B. Montalescot, Gilles Windecker, Stephan Maier, Lars Serpytis, Pranas Serpytis, Rokas Oldroyd, Keith G. Noc, Marko Fuernau, Georg Huber, Kurt Sandri, Marcus de Waha-Thiele, Suzanne Schneider, Steffen Ouarrak, Taoufik Zeymer, Uwe Desch, Steffen Thiele, Holger |
author_sort | Rubini Giménez, Maria |
collection | PubMed |
description | Background: Little is known about clinical outcomes of patients with acute myocardial infraction (AMI) complicated by cardiogenic shock (CS) requiring mechanical ventilation (MV). The aim of this study was to identify the characteristics, risk factors, and outcomes associated with the provision of MV in this specific high-risk population. Methods: Patients with CS complicating AMI and multivessel coronary artery disease from the CULPRIT-SHOCK trial were included. We explored 30 days of clinical outcomes in patients not requiring MV, those with MV on admission, and those in whom MV was initiated within the first day after admission. Results: Among 683 randomized patients included in the analysis, 17.4% received no MV, 59.7% were ventilated at admission and 22.8% received MV within or after the first day after admission. Patients requiring MV had a different risk-profile. Factors independently associated with the provision of MV on admission included higher body weight, resuscitation within 24 h before admission, elevated heart rate and evidence of triple vessel disease. Conclusions: Requiring MV in patients with CS complicating AMI is common and independently associated with mortality after adjusting for covariates. Patients with delayed MV initiation appear to be at higher risk of adverse outcomes. Further research is necessary to identify the optimal timing of MV in this high-risk population. |
format | Online Article Text |
id | pubmed-7141492 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-71414922020-04-15 Outcomes Associated with Respiratory Failure for Patients with Cardiogenic Shock and Acute Myocardial Infarction: A Substudy of the CULPRIT-SHOCK Trial Rubini Giménez, Maria Miller, P. Elliott Alviar, Carlos L. van Diepen, Sean Granger, Christopher B. Montalescot, Gilles Windecker, Stephan Maier, Lars Serpytis, Pranas Serpytis, Rokas Oldroyd, Keith G. Noc, Marko Fuernau, Georg Huber, Kurt Sandri, Marcus de Waha-Thiele, Suzanne Schneider, Steffen Ouarrak, Taoufik Zeymer, Uwe Desch, Steffen Thiele, Holger J Clin Med Article Background: Little is known about clinical outcomes of patients with acute myocardial infraction (AMI) complicated by cardiogenic shock (CS) requiring mechanical ventilation (MV). The aim of this study was to identify the characteristics, risk factors, and outcomes associated with the provision of MV in this specific high-risk population. Methods: Patients with CS complicating AMI and multivessel coronary artery disease from the CULPRIT-SHOCK trial were included. We explored 30 days of clinical outcomes in patients not requiring MV, those with MV on admission, and those in whom MV was initiated within the first day after admission. Results: Among 683 randomized patients included in the analysis, 17.4% received no MV, 59.7% were ventilated at admission and 22.8% received MV within or after the first day after admission. Patients requiring MV had a different risk-profile. Factors independently associated with the provision of MV on admission included higher body weight, resuscitation within 24 h before admission, elevated heart rate and evidence of triple vessel disease. Conclusions: Requiring MV in patients with CS complicating AMI is common and independently associated with mortality after adjusting for covariates. Patients with delayed MV initiation appear to be at higher risk of adverse outcomes. Further research is necessary to identify the optimal timing of MV in this high-risk population. MDPI 2020-03-20 /pmc/articles/PMC7141492/ /pubmed/32245139 http://dx.doi.org/10.3390/jcm9030860 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Rubini Giménez, Maria Miller, P. Elliott Alviar, Carlos L. van Diepen, Sean Granger, Christopher B. Montalescot, Gilles Windecker, Stephan Maier, Lars Serpytis, Pranas Serpytis, Rokas Oldroyd, Keith G. Noc, Marko Fuernau, Georg Huber, Kurt Sandri, Marcus de Waha-Thiele, Suzanne Schneider, Steffen Ouarrak, Taoufik Zeymer, Uwe Desch, Steffen Thiele, Holger Outcomes Associated with Respiratory Failure for Patients with Cardiogenic Shock and Acute Myocardial Infarction: A Substudy of the CULPRIT-SHOCK Trial |
title | Outcomes Associated with Respiratory Failure for Patients with Cardiogenic Shock and Acute Myocardial Infarction: A Substudy of the CULPRIT-SHOCK Trial |
title_full | Outcomes Associated with Respiratory Failure for Patients with Cardiogenic Shock and Acute Myocardial Infarction: A Substudy of the CULPRIT-SHOCK Trial |
title_fullStr | Outcomes Associated with Respiratory Failure for Patients with Cardiogenic Shock and Acute Myocardial Infarction: A Substudy of the CULPRIT-SHOCK Trial |
title_full_unstemmed | Outcomes Associated with Respiratory Failure for Patients with Cardiogenic Shock and Acute Myocardial Infarction: A Substudy of the CULPRIT-SHOCK Trial |
title_short | Outcomes Associated with Respiratory Failure for Patients with Cardiogenic Shock and Acute Myocardial Infarction: A Substudy of the CULPRIT-SHOCK Trial |
title_sort | outcomes associated with respiratory failure for patients with cardiogenic shock and acute myocardial infarction: a substudy of the culprit-shock trial |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7141492/ https://www.ncbi.nlm.nih.gov/pubmed/32245139 http://dx.doi.org/10.3390/jcm9030860 |
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