title: Long-term predictive factors of major adverse cardiac events in patients with acute myocardial infarction complicated by cardiogenic shock.
abstract: BACKGROUND
  Cardiogenic shock (CS) after acute myocardial infarction (AMI) develops in 5-10% of patients and it is associated with high mortality. The aim of this study is to assess the predictive factors of mortality for patients with AMI and CS.
  
  
  METHODS
  Two hundred fifty five AMI patients with CS (the mean age was 66.0 +/- 11.0 years, M:F=156:99) out of 1268 AMI patients who admitted at Chonnam National University Hospital between July 2000 and June 2002 were analyzed according to the clinical characteristics, coronary angiographic findings and MACE during admission and for the 1-year clinical follow-up.
  
  
  RESULTS
  Among the enrolled patients, 129 patients survived without MACE (Group I, mean age 64.2 +/- 10.6 years, M:F=76:53), and 126 patients had MACE (Group II, mean age 68.1 +/- 10.0 years, M:F = 80:46) during admission or during the 1-year follow-up period. There were significant differences in age between the Groups I and II (64.2 +/- 10.6 vs. 68.1 +/- 11.0 years, respectively, p = 0.004) and the previous MI history (0 vs. 17.4%, respectively, p<0.001). The left ventricular ejection fraction (EF) was lower in Group II (Group I vs. II: 49.1 +/- 13.0 vs. 39.1 +/- 12.9%, p < 0.001). The levels of troponin (Tn) I and C-reactive protein (CRP) were higher in Group II (Group I vs. II: 29.2 +/- 7.72 vs. 50.8 +/- 5.17 ng/dL, p = 0.017, 3.8 +/- 0.48 vs. 9.9 +/- 1.21 mg/dL, p < 0.001 respectively). Left main stem lesion (LMSL) was more common in Group II than in Group I (0.7% vs. 22.0%, respectively, p = 0.004). In-hospital death was associated with low Thrombolysis In Myocardial Infarction (TIMI) flow after coronary revascularization.
  
  
  CONCLUSIONS
  Old age, a previous MI history, high Tn and CRP, low EF and LMSL are associated with higher MACE for patients with AMI and CS. Coronary revascularization with TIMI 3 flow lowers the in-hospital mortality.
authors.affiliation: The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea.
authors.forename: Eun Hui
authors.initials: EH
authors.lastname: Bae
authors.forename: Sang Yup
authors.initials: SY
authors.lastname: Lim
authors.forename: Myung Ho
authors.initials: MH
authors.lastname: Jeong
authors.forename: Hyung Wook
authors.initials: HW
authors.lastname: Park
authors.forename: Ji Hyun
authors.initials: JH
authors.lastname: Lim
authors.forename: Young Joon
authors.initials: YJ
authors.lastname: Hong
authors.forename: Weon
authors.initials: W
authors.lastname: Kim
authors.forename: Ju Han
authors.initials: JH
authors.lastname: Kim
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: Soon Pal
authors.initials: SP
authors.lastname: Suh
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; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007723:Korea / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000401:mortality*; D011379:Prognosis; D012770:Shock, Cardiogenic / Q000209:etiology / Q000401:mortality*