Vol 58, No 5 (2003)
Other
Published online: 2005-12-12
Submitted: 2012-12-28
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Acute myocardial infarction complicated by cardiogenic shock. In-hospital and mid-term results of invasive treatment in the National Institute of Cardiology, Warsaw-Anin

Maciej Karcz, Paweł Bekta, Cezary Kępka, Adam Witkowski, Anna Konopka, Zbigniew Chmielak, Artur Dębski, Andrzej Ciszewski, Michał Ciszewski, Krzysztof Cedro, Mirosław Skwarek, Jakub Przyłuski, Mariusz Kruk, Jacek Kądziela, Tomasz Deptuch, Marek Banaszewski, Tomasz Szajewski, Janina Stępińska, Witold Rużyłło
Kardiol Pol 2003;58(5):370-373.
Vol 58, No 5 (2003)
Other
Published online: 2005-12-12
Submitted: 2012-12-28

Abstract

Background: Mortality in acute myocardial infarction (MI) complicated by cardiogenic shock approaches 90%, regardless of the type of pharmacological treatment.
Aim: To assess in-hospital and mid-term results of invasive treatment of patients with acute MI with ST segment elevation (STEMI) complicated by cardiogenic shock.
Methods: From a prospective registry of all patients admitted to our institution for urgent coronary angiography due to acute coronary syndrome between February 2001 and June 2002, patients with STEMI, symptom duration up to 12 hours and cardiogenic shock diagnosed on admission were identified. The in-hospital and mid-term outcome of 37 patients (mean age 65 years, range 54-77, 68% of males) treated with primary percutaneous coronary intervention (PCI) was analysed.
Results: Of the 41 patients with STEMI and cardiogenic shock, total occlusion or critical stenosis of a coronary artery were found in 38 patients. One patient with the occlusion of three main coronary arteries underwent urgent surgical revascularisation and remains alive after an 18-month follow-up. In the remaining 37 patients primary PCI of an infarct-related artery was performed (stent implantation in 70%, abciximab administration in 54%) which restored normal blood flow (TIMI grade 3 flow) in 54% of subjects. In patients with TIMI grade 3 flow the in-hospital mortality was 25%. Of the whole PCI-treated group, 18 (48.6%) patients died during stay in our institution, an additional two - after transfer to another hospital, and one - during a 19-month follow-up period. The remaining 16 patients remain alive (median follow-up of 8 months).
Conclusions: Invasive treatment of patients with STEMI complicated by cardiogenic shock significantly reduces mortality in this high-risk population. The mid-term results in patients discharged from hospital are good. Invasive treatment of acute MI should be accessible for all patients with extensive acute MI.

Abstract

Background: Mortality in acute myocardial infarction (MI) complicated by cardiogenic shock approaches 90%, regardless of the type of pharmacological treatment.
Aim: To assess in-hospital and mid-term results of invasive treatment of patients with acute MI with ST segment elevation (STEMI) complicated by cardiogenic shock.
Methods: From a prospective registry of all patients admitted to our institution for urgent coronary angiography due to acute coronary syndrome between February 2001 and June 2002, patients with STEMI, symptom duration up to 12 hours and cardiogenic shock diagnosed on admission were identified. The in-hospital and mid-term outcome of 37 patients (mean age 65 years, range 54-77, 68% of males) treated with primary percutaneous coronary intervention (PCI) was analysed.
Results: Of the 41 patients with STEMI and cardiogenic shock, total occlusion or critical stenosis of a coronary artery were found in 38 patients. One patient with the occlusion of three main coronary arteries underwent urgent surgical revascularisation and remains alive after an 18-month follow-up. In the remaining 37 patients primary PCI of an infarct-related artery was performed (stent implantation in 70%, abciximab administration in 54%) which restored normal blood flow (TIMI grade 3 flow) in 54% of subjects. In patients with TIMI grade 3 flow the in-hospital mortality was 25%. Of the whole PCI-treated group, 18 (48.6%) patients died during stay in our institution, an additional two - after transfer to another hospital, and one - during a 19-month follow-up period. The remaining 16 patients remain alive (median follow-up of 8 months).
Conclusions: Invasive treatment of patients with STEMI complicated by cardiogenic shock significantly reduces mortality in this high-risk population. The mid-term results in patients discharged from hospital are good. Invasive treatment of acute MI should be accessible for all patients with extensive acute MI.
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Keywords

acute myocardial infarction - cardiogenic shock - primary angioplasty - prognosis

About this article
Title

Acute myocardial infarction complicated by cardiogenic shock. In-hospital and mid-term results of invasive treatment in the National Institute of Cardiology, Warsaw-Anin

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 58, No 5 (2003)

Pages

370-373

Published online

2005-12-12

Bibliographic record

Kardiol Pol 2003;58(5):370-373.

Keywords

acute myocardial infarction - cardiogenic shock - primary angioplasty - prognosis

Authors

Maciej Karcz
Paweł Bekta
Cezary Kępka
Adam Witkowski
Anna Konopka
Zbigniew Chmielak
Artur Dębski
Andrzej Ciszewski
Michał Ciszewski
Krzysztof Cedro
Mirosław Skwarek
Jakub Przyłuski
Mariusz Kruk
Jacek Kądziela
Tomasz Deptuch
Marek Banaszewski
Tomasz Szajewski
Janina Stępińska
Witold Rużyłło

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