title: Short- and long-term major adverse cardiac events in patients undergoing percutaneous coronary intervention with stenting for acute myocardial infarction complicated by cardiogenic shock.
abstract: OBJECTIVE
  To determine the risk of short- and long-term mortality and major adverse cardiac events (MACE) in acute myocardial infarction (AMI) patients complicated by cardiogenic shock (CS) in the contemporary practice of primary percutaneous coronary intervention with stenting.
  
  
  METHODS
  Of the 1,755 consecutive AMI patients undergoing percutaneous coronary intervention with stenting enrolled, 103 had CS at admission. Primary endpoints were early mortality (within 30 days after the index event) and late mortality (from day 31 up to 4 years). Secondary endpoints included MACE [all-cause death, myocardial infarction or target vessel revascularization (TVR)], myocardial infarction, TVR and stent thrombosis.
  
  
  RESULTS
  Thirty-day mortality was higher among CS patients, and CS was a strong independent predictor of a higher risk of early death (adjusted HR 3.64, 95% CI 2.44-5.44). The late mortality rate was significantly higher in CS patients, and CS was also a predictor of higher risk of death at a 4-year follow-up (adjusted HR 1.95, 95% CI 1.11-3.45). Recurrent AMI, TVR and stent thrombosis rates were similar among patients with and without CS.
  
  
  CONCLUSIONS
  CS complicating AMI is still a severe clinical event, mainly with regard to a significant higher risk of early mortality, but also associated with a worse prognosis in 30-day survivors.
authors.affiliation: Department of Cardiology, Erasmus MC, 's Gravendijkwal 230, Rotterdam, The Netherlands.
authors.forename: Milena Soriano
authors.initials: MS
authors.lastname: Marcolino
authors.forename: Cihan
authors.initials: C
authors.lastname: Simsek
authors.forename: Sanneke P M
authors.initials: SP
authors.lastname: de Boer
authors.forename: Ron T
authors.initials: RT
authors.lastname: van Domburg
authors.forename: Robert-Jan
authors.initials: RJ
authors.lastname: van Geuns
authors.forename: Peter
authors.initials: P
authors.lastname: de Jaegere
authors.forename: K Martijn
authors.initials: KM
authors.lastname: Akkerhuis
authors.forename: Joost
authors.initials: J
authors.lastname: Daemen
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Serruys
authors.forename: Eric
authors.initials: E
authors.lastname: Boersma
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects* / Q000401:mortality; D001026:Coronary Artery Bypass / Q000401:mortality; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000401:mortality / Q000628:therapy*; D009204:Myocardial Revascularization / Q000401:mortality; D017239:Paclitaxel / Q000008:administration & dosage; D011379:Prognosis; D012770:Shock, Cardiogenic / Q000150:complications* / Q000401:mortality; D020123:Sirolimus / Q000008:administration & dosage; D015607:Stents; D050257:Tubulin Modulators / Q000008:administration & dosage
chemical_list: D050257:Tubulin Modulators; D017239:Paclitaxel; D020123:Sirolimus