PMID- 22739496
OWN - NLM
STAT- MEDLINE
DCOM- 20121119
LR  - 20120802
IS  - 1421-9751 (Electronic)
IS  - 0008-6312 (Linking)
VI  - 122
IP  - 2
DP  - 2012
TI  - Outcome of patients presenting with ST elevation myocardial infarct and 
      cardiogenic shock: a contemporary single center's experience.
PG  - 83-8
LID - 10.1159/000338165 [doi]
AB  - OBJECTIVES: Acute ST elevation myocardial infarction (STEMI) presenting with 
      cardiogenic shock (CS) is associated with dismal prognosis. In the last years, 
      significant advances have been made in reperfusion techniques and pharmacological 
      treatment. Therefore, we aimed to assess the outcome of these patients during the 
      past decade and identify major factors that impact their prognosis. METHODS: We 
      identified 170 patients who presented with STEMI, CS, and underwent primary 
      percutaneous coronary intervention (PCI) between 2001 and 2011. Patients were 
      allocated into two groups based on period of presentation: 2001-2005 (n = 70) and 
      2006-2011 (n = 100). Clinical outcomes up to 6 months were evaluated. RESULTS: 
      Patients in the latter period were younger, and had lower rates of renal failure 
      and higher rates of stent use. Despite these differences, mortality did not 
      differ and remained high in both periods (52-59% at 6 months). Time frames from 
      onset of symptoms to arrival to the emergency department and to performance of 
      coronary intervention were similar in both periods. Intra-aortic balloon pump use 
      was similar in both periods. In multivariate analysis, factors associated with 
      1-month mortality were: diabetes (OR = 3.6, 1.4-9.4, p = 0.007), LVEF <40% (OR = 
      1.8, 1.3-2.6, p = 0.001), GFR <60 ml/min/m(2) (OR = 1.8, 1.3-2.4, p < 0.009) and 
      glycoprotein IIb/IIIa inhibitor use (OR = 0.5, 0.2-1.1, p = 0.08). The 
      combination of diabetes and renal failure was associated with particularly high 
      mortality. CONCLUSIONS: Prognosis of patients presenting with STEMI, CS, and 
      treated with primary PCI during the past decade, remains poor. Better 
      risk-stratification may help improve their grave outcome.
CI  - Copyright (c) 2012 S. Karger AG, Basel.
FAU - Greenberg, Gabriel
AU  - Greenberg G
AD  - Department of Cardiology, Rabin Medical Center, Petach-Tikva, affiliated with the 
      Sackler Faculty of Medicine, Tel Aviv, Israel.
FAU - Assali, Abid
AU  - Assali A
FAU - Assa-Vaknin, Hanna
AU  - Assa-Vaknin H
FAU - Brosh, David
AU  - Brosh D
FAU - Teplitsky, Igal
AU  - Teplitsky I
FAU - Battler, Alexander
AU  - Battler A
FAU - Kornowski, Ran
AU  - Kornowski R
FAU - Lev, Eli I
AU  - Lev EI
LA  - eng
PT  - Journal Article
DEP - 20120622
PL  - Switzerland
TA  - Cardiology
JT  - Cardiology
JID - 1266406
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - *Angioplasty, Balloon, Coronary
MH  - Diabetic Angiopathies/complications/therapy
MH  - Diabetic Nephropathies/complications
MH  - Female
MH  - Hospitalization
MH  - Humans
MH  - Kidney Failure, Chronic/complications
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*complications/therapy
MH  - Prospective Studies
MH  - Shock, Cardiogenic/*complications
MH  - Treatment Outcome
EDAT- 2012/06/29 06:00
MHDA- 2012/12/10 06:00
CRDT- 2012/06/29 06:00
PHST- 2011/05/30 00:00 [received]
PHST- 2012/03/11 00:00 [accepted]
PHST- 2012/06/29 06:00 [entrez]
PHST- 2012/06/29 06:00 [pubmed]
PHST- 2012/12/10 06:00 [medline]
AID - 000338165 [pii]
AID - 10.1159/000338165 [doi]
PST - ppublish
SO  - Cardiology. 2012;122(2):83-8. doi: 10.1159/000338165. Epub 2012 Jun 22.