Drakos Stavros G, Bonios Michael J, Anastasiou-Nana Maria I, Tsagalou Eleftheria P, Terrovitis John V, Kaldara Elisabet, Maroulidis George, Nanas Serafim N, Kanakakis John, Nanas John N
Third Cardiology Department, University of Athens School of Medicine, Athens, Greece.
Clin Cardiol. 2009 Aug;32(8):E4-8. doi: 10.1002/clc.20488.
Cardiogenic shock is the leading cause of death during hospitalization for acute myocardial infarction (MI). However, little data exist regarding the long-term outcomes of patients who survived the acute phase of MI and were discharged from the hospital.
We retrospectively reviewed the records of 81 consecutive patients referred for management of acute MI and cardiogenic shock to analyze their in-hospital and long-term outcomes.
Mean systemic systolic and central venous pressures at presentation were 74 +/- 15 and 17 +/- 7 mm Hg, respectively. Intra-aortic balloon counterpulsation (IABC) was implemented in all patients for a mean of 88 +/- 83 hours. Thrombolytics were administered in 49% and mechanical ventilation applied in 46% of patients. Primary angioplasty could not be performed in any patient, while 17 patients later underwent myocardial revascularization during hospitalization. There were 37 in-hospital survivors (45.7%). The 1-year survival after discharge from the hospital was 87.6% in the overall population, versus 100% among patients who underwent in-hospital myocardial revascularization, versus 78.9% among nonrevascularized patients (p = 0.079). Over a mean follow-up of 85 +/- 47 mo, survival after discharge from the index hospitalization was 44.9% in the overall population, versus 56.2% among revascularized patients, versus 36.4% among nonrevascularized patients (p = 0.277). Heart failure developed in 51.6% of patients who were discharged from the hospital.
In this single center analysis, the long-term survival after acute MI complicated by cardiogenic shock was high with nearly 50% of patients surviving free from heart failure.
心源性休克是急性心肌梗死（MI）住院期间的主要死亡原因。然而，关于MI急性期存活并出院患者的长期预后数据较少。
我们回顾性分析了81例因急性MI和心源性休克转诊接受治疗患者的记录，以分析其住院期间及长期预后。
就诊时平均体循环收缩压和中心静脉压分别为74±15和17±7 mmHg。所有患者均接受主动脉内球囊反搏（IABC）治疗，平均治疗时间为88±83小时。49%的患者接受了溶栓治疗，46%的患者接受了机械通气。所有患者均无法进行直接血管成形术，17例患者在住院期间接受了心肌血运重建。37例患者存活出院（45.7%）。总体人群出院后1年生存率为87.6%，住院期间接受心肌血运重建的患者为100%，未接受血运重建的患者为78.9%（p = 0.079）。平均随访85±47个月，首次住院出院后的总体生存率为44.9%，血运重建患者为56.2%，未接受血运重建的患者为36.4%（p = 0.277）。出院患者中有51.6%发生心力衰竭。
在本单中心分析中，急性MI合并心源性休克后的长期生存率较高，近50%的患者存活且未发生心力衰竭。
