Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
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
_version_ 1783519204620632064
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
work_keys_str_mv AT rubinigimenezmaria outcomesassociatedwithrespiratoryfailureforpatientswithcardiogenicshockandacutemyocardialinfarctionasubstudyoftheculpritshocktrial
AT millerpelliott outcomesassociatedwithrespiratoryfailureforpatientswithcardiogenicshockandacutemyocardialinfarctionasubstudyoftheculpritshocktrial
AT alviarcarlosl outcomesassociatedwithrespiratoryfailureforpatientswithcardiogenicshockandacutemyocardialinfarctionasubstudyoftheculpritshocktrial
AT vandiepensean outcomesassociatedwithrespiratoryfailureforpatientswithcardiogenicshockandacutemyocardialinfarctionasubstudyoftheculpritshocktrial
AT grangerchristopherb outcomesassociatedwithrespiratoryfailureforpatientswithcardiogenicshockandacutemyocardialinfarctionasubstudyoftheculpritshocktrial
AT montalescotgilles outcomesassociatedwithrespiratoryfailureforpatientswithcardiogenicshockandacutemyocardialinfarctionasubstudyoftheculpritshocktrial
AT windeckerstephan outcomesassociatedwithrespiratoryfailureforpatientswithcardiogenicshockandacutemyocardialinfarctionasubstudyoftheculpritshocktrial
AT maierlars outcomesassociatedwithrespiratoryfailureforpatientswithcardiogenicshockandacutemyocardialinfarctionasubstudyoftheculpritshocktrial
AT serpytispranas outcomesassociatedwithrespiratoryfailureforpatientswithcardiogenicshockandacutemyocardialinfarctionasubstudyoftheculpritshocktrial
AT serpytisrokas outcomesassociatedwithrespiratoryfailureforpatientswithcardiogenicshockandacutemyocardialinfarctionasubstudyoftheculpritshocktrial
AT oldroydkeithg outcomesassociatedwithrespiratoryfailureforpatientswithcardiogenicshockandacutemyocardialinfarctionasubstudyoftheculpritshocktrial
AT nocmarko outcomesassociatedwithrespiratoryfailureforpatientswithcardiogenicshockandacutemyocardialinfarctionasubstudyoftheculpritshocktrial
AT fuernaugeorg outcomesassociatedwithrespiratoryfailureforpatientswithcardiogenicshockandacutemyocardialinfarctionasubstudyoftheculpritshocktrial
AT huberkurt outcomesassociatedwithrespiratoryfailureforpatientswithcardiogenicshockandacutemyocardialinfarctionasubstudyoftheculpritshocktrial
AT sandrimarcus outcomesassociatedwithrespiratoryfailureforpatientswithcardiogenicshockandacutemyocardialinfarctionasubstudyoftheculpritshocktrial
AT dewahathielesuzanne outcomesassociatedwithrespiratoryfailureforpatientswithcardiogenicshockandacutemyocardialinfarctionasubstudyoftheculpritshocktrial
AT schneidersteffen outcomesassociatedwithrespiratoryfailureforpatientswithcardiogenicshockandacutemyocardialinfarctionasubstudyoftheculpritshocktrial
AT ouarraktaoufik outcomesassociatedwithrespiratoryfailureforpatientswithcardiogenicshockandacutemyocardialinfarctionasubstudyoftheculpritshocktrial
AT zeymeruwe outcomesassociatedwithrespiratoryfailureforpatientswithcardiogenicshockandacutemyocardialinfarctionasubstudyoftheculpritshocktrial
AT deschsteffen outcomesassociatedwithrespiratoryfailureforpatientswithcardiogenicshockandacutemyocardialinfarctionasubstudyoftheculpritshocktrial
AT thieleholger outcomesassociatedwithrespiratoryfailureforpatientswithcardiogenicshockandacutemyocardialinfarctionasubstudyoftheculpritshocktrial