title: Predictive factors of major adverse cardiac events in acute myocardial infarction patients complicated by cardiogenic shock undergoing primary percutaneous coronary intervention.
abstract: 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.
authors.affiliation: The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea.
authors.forename: Sang Yup
authors.initials: SY
authors.lastname: Lim
authors.forename: Myung Ho
authors.initials: MH
authors.lastname: Jeong
authors.forename: Eun Hui
authors.initials: EH
authors.lastname: Bae
authors.forename: Weon
authors.initials: W
authors.lastname: Kim
authors.forename: Ju Han
authors.initials: JH
authors.lastname: Kim
authors.forename: Young Joon
authors.initials: YJ
authors.lastname: Hong
authors.forename: Hyung Wook
authors.initials: HW
authors.lastname: Park
authors.forename: Dong Goo
authors.initials: DG
authors.lastname: Kang
authors.forename: Yeon Sang
authors.initials: YS
authors.lastname: Lee
authors.forename: Kye Hun
authors.initials: KH
authors.lastname: Kim
authors.forename: Sang Hyun
authors.initials: SH
authors.lastname: Lee
authors.forename: Kyung Ho
authors.initials: KH
authors.lastname: Yun
authors.forename: Seo Na
authors.initials: SN
authors.lastname: Hong
authors.forename: Jeong Gwan
authors.initials: JG
authors.lastname: Cho
authors.forename: Young Keun
authors.initials: YK
authors.lastname: Ahn
authors.forename: Jong Chun
authors.initials: JC
authors.lastname: Park
authors.forename: Byoung Hee
authors.initials: BH
authors.lastname: Ahn
authors.forename: Sang Hyung
authors.initials: SH
authors.lastname: Kim
authors.forename: Jung Chaee
authors.initials: JC
authors.lastname: Kang
mesh_terms: 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