Predictive factors of major adverse cardiac events in acute myocardial infarction patients complicated by cardiogenic shock undergoing primary percutaneous coronary intervention.
BACKGROUND
The aim of this study was to assess in-hospital mortality and major adverse cardiac events (MACE) during long-term clinical follow-up of patients who developed cardiogenic shock (CS) after acute myocardial infarction (AMI) and who underwent primary percutaneous coronary intervention (PCI).


RESULTS
The data from 147 patients with CS after AMI (61.7 +/-10.4 years, M:F =156:99) who underwent primary PCI at Chonnam National University Hospital between January 1999 and December 2002 were analyzed: clinical characteristics, coronary angiographic findings and mortality during admission, and MACE during a 1-year clinical follow-up. Of the enrolled patients, 121 patients survived (group I, M:F =94:27) and 26 died (group II, M:F =14:12) during admission. By binary logistic regression analysis, in-hospital death was associated with low Thrombolysis In Myocardial Infarction (TIMI) flow after coronary revascularization (p=0.02, odds ratio (OR) =1.3). Eighty-nine patients (60.5%) survived without MACE during the 1-year clinical follow-up and MACE was associated with a C-reactive protein (CRP) of more than 1 mg/dl (p=0.002, OR =6.3) and low TIMI flow after coronary revascularization (p<0.001, OR =7.8).


CONCLUSIONS
Primary PCI achieving TIMI 3 flow reduces in-hospital death in AMI with CS. High concentration of CRP and low TIMI flow are associated with MACE during long-term clinical follow-up.
Lim
Sang Yup
SY
The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea.
Jeong
Myung Ho
MH
Bae
Eun Hui
EH
Kim
Weon
W
Kim
Ju Han
JH
Hong
Young Joon
YJ
Park
Hyung Wook
HW
Kang
Dong Goo
DG
Lee
Yeon Sang
YS
Kim
Kye Hun
KH
Lee
Sang Hyun
SH
Yun
Kyung Ho
KH
Hong
Seo Na
SN
Cho
Jeong Gwan
JG
Ahn
Young Keun
YK
Park
Jong Chun
JC
Ahn
Byoung Hee
BH
Kim
Sang Hyung
SH
Kang
Jung Chaee
JC
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D005260:Female; D006331:Heart Diseases / Q000175:diagnosis; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000401:mortality* / Q000628:therapy; D009204:Myocardial Revascularization; D011379:Prognosis; D012770:Shock, Cardiogenic / Q000209:etiology / Q000401:mortality* / Q000628:therapy; D015996:Survival Rate; D015912:Thrombolytic Therapy