title: Mortality of patients with ST-segment elevation myocardial infarction and cardiogenic shock treated by PCI is correlated to the infarct-related artery--results from the PL-ACS Registry.
abstract: BACKGROUND
  Mortality of patients with ST-segment elevation myocardial infarction (STEMI) with cardiogenic shock (CS) on admission remains high despite invasive treatment. The aim of this analysis was to assess the relationship between the infarct-related artery (IRA) and the early and 12-month outcomes of patients with STEMI and CS treated by percutaneous coronary intervention (PCI).
  
  
  METHODS
  Two thousand ninety patients with STEMI and CS registered in the prospective Polish Registry of Acute Coronary Syndromes from October 2003 to November 2009 were included.
  
  
  RESULTS
  The in-hospital mortality in the left main (LM), left anterior descending artery (LAD), circumflex artery (Cx), and right coronary artery (RCA) groups was 64.7%, 41.0%, 36.0%, and 30.8%, respectively, with p<0.0001. The 12-month mortality in the LM, LAD, Cx, and RCA groups was 77.7%, 58.2%, 55.1%, and 45.0%, respectively, with p<0.0001. After multivariate adjustment, LM as the IRA was significantly associated with higher 12-month mortality (hazard ratio=1.71, 95% confidence interval=1.28-2.27, p=0.0002).
  
  
  CONCLUSIONS
  In-hospital and long-term mortality of patients with STEMI and CS treated by PCI are significantly correlated to the IRA, being highest for LM and lowest for RCA.
authors.affiliation: 3rd Department of Cardiology, Silesian Medical University, Silesian Center for Heart Diseases, Zabrze, Poland. przemyslaw.t@wp.pl
authors.forename: Przemysław
authors.initials: P
authors.lastname: Trzeciak
authors.forename: Marek
authors.initials: M
authors.lastname: Gierlotka
authors.forename: Mariusz
authors.initials: M
authors.lastname: Gąsior
authors.forename: Andrzej
authors.initials: A
authors.lastname: Lekston
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Wilczek
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Słonka
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Kalarus
authors.forename: Marian
authors.initials: M
authors.lastname: Zembala
authors.forename: Bartosz
authors.initials: B
authors.lastname: Hudzik
authors.forename: Lech
authors.initials: L
authors.lastname: Poloński
mesh_terms: D000368:Aged; D003331:Coronary Vessels / Q000473:pathology*; D005260:Female; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality* / Q000628:therapy; D062645:Percutaneous Coronary Intervention / Q000401:mortality* / Q000639:trends; D011044:Poland; D011446:Prospective Studies; D012042:Registries; D012770:Shock, Cardiogenic / Q000401:mortality* / Q000628:therapy; D016896:Treatment Outcome