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Cardiogenic Shock Does Not Portend Poor Long-Term Survival in Patients Undergoing Primary Percutaneous Coronary Intervention

Although a strong association of cardiogenic shock (CS) with in-hospital mortality in patients with acute coronary syndrome (ACS) is well established, less attention has been paid to its prognostic influence on long-term outcome. We evaluated the impact of CS in 1173 patients undergoing primary perc...

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Autores principales: Steinacher, Eva, Hofer, Felix, Kazem, Niema, Hammer, Andreas, Koller, Lorenz, Lang, Irene, Hengstenberg, Christian, Niessner, Alexander, Sulzgruber, Patrick
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9330812/
https://www.ncbi.nlm.nih.gov/pubmed/35893287
http://dx.doi.org/10.3390/jpm12081193
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author Steinacher, Eva
Hofer, Felix
Kazem, Niema
Hammer, Andreas
Koller, Lorenz
Lang, Irene
Hengstenberg, Christian
Niessner, Alexander
Sulzgruber, Patrick
author_facet Steinacher, Eva
Hofer, Felix
Kazem, Niema
Hammer, Andreas
Koller, Lorenz
Lang, Irene
Hengstenberg, Christian
Niessner, Alexander
Sulzgruber, Patrick
author_sort Steinacher, Eva
collection PubMed
description Although a strong association of cardiogenic shock (CS) with in-hospital mortality in patients with acute coronary syndrome (ACS) is well established, less attention has been paid to its prognostic influence on long-term outcome. We evaluated the impact of CS in 1173 patients undergoing primary percutaneous coronary interventions between 1997 and 2009. Patients were followed up until the primary study endpoint (cardiovascular mortality) was reached. Within the entire study population, 112 (10.4%) patients presented with CS at admission. After initial survival, CS had no impact on mortality (non-CS: 23.5% vs. CS: 24.0%; p = 0.923), with an adjusted hazard ratio of 1.18 (95% CI: 0.77–1.81; p = 0.457). CS patients ≥ 55 years (p = 0.021) with moderately or severely impaired left ventricular function (LVF; p = 0.039) and chronic kidney disease (CKD; p = 0.013) had increased risk of cardiovascular mortality during follow-up. The present investigation extends currently available evidence that cardiovascular survival in CS is comparable with non-CS patients after the acute event. CS patients over 55 years presenting with impaired LVF and CKD at the time of ACS are at increased risk for long-term mortality and could benefit from personalized secondary prevention.
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spelling pubmed-93308122022-07-29 Cardiogenic Shock Does Not Portend Poor Long-Term Survival in Patients Undergoing Primary Percutaneous Coronary Intervention Steinacher, Eva Hofer, Felix Kazem, Niema Hammer, Andreas Koller, Lorenz Lang, Irene Hengstenberg, Christian Niessner, Alexander Sulzgruber, Patrick J Pers Med Article Although a strong association of cardiogenic shock (CS) with in-hospital mortality in patients with acute coronary syndrome (ACS) is well established, less attention has been paid to its prognostic influence on long-term outcome. We evaluated the impact of CS in 1173 patients undergoing primary percutaneous coronary interventions between 1997 and 2009. Patients were followed up until the primary study endpoint (cardiovascular mortality) was reached. Within the entire study population, 112 (10.4%) patients presented with CS at admission. After initial survival, CS had no impact on mortality (non-CS: 23.5% vs. CS: 24.0%; p = 0.923), with an adjusted hazard ratio of 1.18 (95% CI: 0.77–1.81; p = 0.457). CS patients ≥ 55 years (p = 0.021) with moderately or severely impaired left ventricular function (LVF; p = 0.039) and chronic kidney disease (CKD; p = 0.013) had increased risk of cardiovascular mortality during follow-up. The present investigation extends currently available evidence that cardiovascular survival in CS is comparable with non-CS patients after the acute event. CS patients over 55 years presenting with impaired LVF and CKD at the time of ACS are at increased risk for long-term mortality and could benefit from personalized secondary prevention. MDPI 2022-07-22 /pmc/articles/PMC9330812/ /pubmed/35893287 http://dx.doi.org/10.3390/jpm12081193 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/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 (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Steinacher, Eva
Hofer, Felix
Kazem, Niema
Hammer, Andreas
Koller, Lorenz
Lang, Irene
Hengstenberg, Christian
Niessner, Alexander
Sulzgruber, Patrick
Cardiogenic Shock Does Not Portend Poor Long-Term Survival in Patients Undergoing Primary Percutaneous Coronary Intervention
title Cardiogenic Shock Does Not Portend Poor Long-Term Survival in Patients Undergoing Primary Percutaneous Coronary Intervention
title_full Cardiogenic Shock Does Not Portend Poor Long-Term Survival in Patients Undergoing Primary Percutaneous Coronary Intervention
title_fullStr Cardiogenic Shock Does Not Portend Poor Long-Term Survival in Patients Undergoing Primary Percutaneous Coronary Intervention
title_full_unstemmed Cardiogenic Shock Does Not Portend Poor Long-Term Survival in Patients Undergoing Primary Percutaneous Coronary Intervention
title_short Cardiogenic Shock Does Not Portend Poor Long-Term Survival in Patients Undergoing Primary Percutaneous Coronary Intervention
title_sort cardiogenic shock does not portend poor long-term survival in patients undergoing primary percutaneous coronary intervention
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9330812/
https://www.ncbi.nlm.nih.gov/pubmed/35893287
http://dx.doi.org/10.3390/jpm12081193
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