title: [Mortality prognostic factors of cardiogenic shock complicating an acute myocardial infarction and treated by percutaneous coronary intervention].
abstract: OBJECTIVE
  To determine the in-hospital prognosis and late outcome of cardiogenic shock complicating acute myocardial infarction treated by early (< 24 hours) percutaneous coronary intervention (PCI).
  
  
  METHODS
  Retrospective monocentric study of a consecutive cohort of patients undergoing early PCI (< 24 heures) for cardiogenic shock complicating acute myocardial infarction from 1994 to 2004.
  
  
  RESULTS
  The cohort included 175 patients (mean age = 65 +/- 14 years, 68% male). A successful PCI was obtained in 69% of patients. The in-hospital mortality was 43%. Independent risk factors associated with an increased mortality were: absence of TIMI three flow (P < 0.0001), absence of smoking (P < 0.009) and the need for mechanical ventilation (P < 0.002). Nor stent use or anti GP IIb/IIa infusions were predictors of a better outcome. At hospital discharge, mean left ventricular ejection fraction (LVEF) was 38 +/- 12%. Kaplan-Meier estimate of survival was 63% for in-hospital survivors (maximum follow-up = 9 years). Independent predictors of an impaired long-term outcome were: a LVEF < 0.3 (P < 0.028) and 3-vessel disease on coronary angiography (P < 0.004).
  
  
  CONCLUSIONS
  In-hospital mortality of patients suffering cardiogenic shock complicating acute myocardial infarction and treated by PCI remains high despite PCI improvement. The long-term survival appears, however, to be better than that of patients with coronary artery disease and low LVEF.
authors.affiliation: Département de cardiologie, CHU de Nancy, allée du Morvan, 54511 Vandoeuvre-Lès-Nancy, France. anne.chodek@laposte.net
authors.forename: A
authors.initials: A
authors.lastname: Chodek
authors.forename: M
authors.initials: M
authors.lastname: Angioi
authors.forename: M
authors.initials: M
authors.lastname: Fajraoui
authors.forename: F
authors.initials: F
authors.lastname: Moulin
authors.forename: T
authors.initials: T
authors.lastname: Chouihed
authors.forename: P
authors.initials: P
authors.lastname: Maurer
authors.forename: C
authors.initials: C
authors.lastname: Méjean
authors.forename: J P
authors.initials: JP
authors.lastname: Carteaux
authors.forename: B
authors.initials: B
authors.lastname: Popovic
authors.forename: R
authors.initials: R
authors.lastname: Piquemal
authors.forename: G
authors.initials: G
authors.lastname: Ethévenot
authors.forename: E
authors.initials: E
authors.lastname: Aliot
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D015331:Cohort Studies; D003627:Data Interpretation, Statistical; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000628:therapy; D011379:Prognosis; D012189:Retrospective Studies; D012770:Shock, Cardiogenic / Q000209:etiology / Q000401:mortality* / Q000628:therapy; D013318:Stroke Volume; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left