title: Primary percutaneous coronary intervention for ST elevation myocardial infarction complicated by cardiogenic shock.
abstract: OBJECTIVE
  To determine the outcomes of primary percutaneous coronary intervention for ST elevation myocardial infarction complicated by cardiogenic shock.
  
  
  METHODS
  The retrospective study was conducted at the Tabba Heart Institute, a private-sector facility in Karachi. It reviewed the medical records of 56 consecutive patients between January 2009 and June 2011 with acute ST elevation myocardial infarction complicated by cardiogenic shock and subjected to primary percutaneous coronary intervention. The primary end point was in-hospital mortality and its predictors. SPSS 14 was used for statistical analysis.
  
  
  RESULTS
  The mean age of the study patients was 63 +/- 11.7 years; 38 (68%) were male; 32 (57%) were hypertensive; and 39 (69%) were diabetic. Most infarcts were anterior in location (n = 36; 64%). Besides, 33 (59%) required ventilatory support. Intra-aortic balloon pump was placed in 30 (54%), and 33 (59%) patients had multivessel coronary artery disease. In-hospital mortality occurred in 26 (46%). Multivariate logistic regression analysis showed that age > 60 years (p < 0.05), diabetes (p < 0.01) and left ventricular ejection fraction < 40% (p < 0.01) were independent predictors of in-hospital mortality.
  
  
  CONCLUSIONS
  Results emphasise the need of aggressive management of patients with cardiogenic shock utilising primary percutaneous coronary intervention as a reperfusion strategy to improve clinical outcomes.
authors.affiliation: Tabba Heart Institute, Karachi, Pakistan. ahsdr1977@yahoo.com
authors.forename: Ayaz Hussain
authors.initials: AH
authors.lastname: Shaikh
authors.forename: Bashir
authors.initials: B
authors.lastname: Hanif
authors.forename: Asad
authors.initials: A
authors.lastname: Pathan
authors.forename: Waqar
authors.initials: W
authors.lastname: Khan
authors.forename: Shahrukh
authors.initials: S
authors.lastname: Hashmani
authors.forename: Mohsin
authors.initials: M
authors.lastname: Raza
authors.forename: Sumaira
authors.initials: S
authors.lastname: Nasir
mesh_terms: D000368:Aged; D048909:Diabetes Complications / Q000150:complications; D004562:Electrocardiography; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D012189:Retrospective Studies; D012307:Risk Factors; D012770:Shock, Cardiogenic / Q000150:complications / Q000503:physiopathology* / Q000601:surgery*; D013318:Stroke Volume