[Clinical features and treatment of cardiogenic shock complicated with acute myocardial infarction].
OBJECTIVE
To identify the clinical features and the outcome of patients with cardiogenic shock complicating acute myocardial infarction (AMI).


METHODS
One hundred and eight consecutive patients with AMI were included in this retrospective analysis. The characteristics, management, and outcome of patients with AMI were compared between patients with cardiogenic shock (group A, n=11) and without cardiogenic shock (group B, n=9).


RESULTS
There was no difference in the age and other characteristics including proportion of women, diabetics, prior myocardial infarction and the position of myocardial infarction. The levels of peak creatine kinase and troponin I were (31979.7+/-22271.1)nmol x s(-1) x L(-1) and (90.7+/-61.1) microg/L respectively in group A, they were higher than those in group B (17795.2+/-14979.7)nmol.s-1.L-1 and (39.9+/-52.1) microg/L, respectively (both P<0.05). The left ventricular ejection fraction was significantly lower in group A than that in group B (0.46+/-0.12 vs. 0.55+/-0.12, P<0.05). Patients in group A had a higher proportion of pump failure, arrhythmia and pneumonia (64% vs. 14%, P<0.001; 55% vs. 21 %, P<0.05; and 46% vs. 12%, P<0.01, respectively) than those in group B. In addition, in group A patients often underwent thrombolysis of urokinase, coronary angiography and intra-aortic balloon counterpulsation (46% vs. 18%, 73% vs. 26% and 36% vs. 4%, all P<0.05, respectively). There was no difference in in-hospital mortality between group A and group B (0 vs. 4%, P>0.05).


CONCLUSIONS
Shock patients more likely have pump failure, arrhythmia, and pneumonia and more often underwent intra-aortic balloon counterpulsation. If cardiogenic shock complicating AMI is managed with rapid evaluation and prompt initiation of supportive measures and definitive therapy, outcomes can be improved.
Institute of Geriatric Cardiology, General Hospital of Chinese PLA, Beijing 100853, China. zys3012002@yahoo.com
Yu-sheng
YS
Zhao
Shi-wen
SW
Wang
Cai-yi
CY
Lu
Xing-li
XL
Wu
Yu-feng
YF
Li
Ling-ling
LL
Liu
Mu-yang
MY
Yan
Rui
R
Cheng
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D003402:Creatine Kinase / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012770:Shock, Cardiogenic / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D019210:Troponin I / Q000097:blood; D016277:Ventricular Function, Left
D019210:Troponin I; D003402:Creatine Kinase