- 期刊
Predictors of In-Hospital Mortality in Patients with Successful Primary Coronary Intervention for Acute ST-Elevation Myocardial Infarction Presenting as Cardiogenic Shock
並列摘要
Background: Predictors of hospital mortality in patients with successful primary coronary angioplasty for ST-elevation myocardial infarction (STEMT) presenting as cardiogenic shock (CS) remained less specified. Methods: From 1996 to 2007, we evaluated 64 patients (56men, 65±14 years) with STEMI and CS receiving successful intervention defined as residual stenosis＜40% by balloon angioplasty or＜20% by stenting with a TIMI grade 2 or 3 flow in the infarct-related artery. Results: Among the 64 patients, 37 (58%) had anterior infarction, and 26 (41%) had inferior infarction. In-hospital death occurred to 21 (33%) patients with a mean hospital stay of 11±18 days. Hospital morta1ity was associated with several pre-and peri-procedural parameters including initial higher white blood cell (16,629±6492 vs. 13,093±53871/μL) and serum creatinine (1.7±0.6 vs. 1.2±0.3mg/dl) levels, anterior infarction (76 vs.49%), less stenting (38vs.65%), and post-intervention TIMI grade 2 flow (57 vs. 14%) (all p＜0.05). After multivariate analysis, initial creatinine ≥1.4mg/dl (odds ratio: 8.9; p=0.011, 95% confidence interval: 1.7-47.7), and anterior infarction (odds ratio: 5.9; p=0.038, 95% confidence interval: 1.1-31.3) were independent predictors of in-hospital death. Conclusion: Anterior infarction or early renal dysfunction remained critical to the one-third mortality of successful intervention for patients with STEMT and CS.
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延伸閱讀
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