Hayıroğlu Mert İlker, Keskin Muhammed, Uzun Ahmet Okan, Yıldırım Duygu İlke, Kaya Adnan, Çinier Göksel, Bozbeyoğlu Emrah, Yıldırımtürk Özlem, Kozan Ömer, Pehlivanoğlu Seçkin
Department of Cardiology, Haydapasa Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey.
Department of Cardiology, Haydapasa Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey.
Heart Lung Circ. 2019 Feb;28(2):237-244. doi: 10.1016/j.hlc.2017.10.023. Epub 2017 Nov 14.
ST-segment elevation myocardial infarction (STEMI) complicated with cardiogenic shock (CS) remains as an unresolved condition causing high morbidity and mortality despite advances in medical treatment and coronary intervention procedures. In the current study, we evaluated the predictors of in-hospital mortality of STEMI complicated with CS.
In this retrospective study, we evaluated the predictive value of baseline characteristics, angiographic, echocardiographic and laboratory parameters on in-hospital mortality of 319 patients with STEMI complicated with CS who were treated with primary percutaneous coronary intervention. Patients were divided into two groups consisting of survivors and non-survivors during their index hospitalisation period.
The mortality rate was found to be 61.3% in the study population. At multivariate analysis after adjustment for the parameters detected in univariate analysis, chronic renal failure, Thrombolysis In Myocardial Infarction (TIMI) post percutaneous coronary intervention (PCI) ≤2, plasma glucose and lactate level, blood urea nitrogen level, Tricuspid Annular Plane Systolic Excursion (TAPSE) and ejection fraction were independent predictors of in-hospital mortality.
Apart from haemodynamic deterioration, angiographic, echocardiographic and laboratory parameters have an impact on in-hospital mortality in patients with STEMI complicated with CS.
尽管在药物治疗和冠状动脉介入手术方面取得了进展，但ST段抬高型心肌梗死（STEMI）合并心源性休克（CS）仍然是一种未得到解决的疾病，导致高发病率和死亡率。在本研究中，我们评估了STEMI合并CS患者院内死亡的预测因素。
在这项回顾性研究中，我们评估了319例接受直接经皮冠状动脉介入治疗的STEMI合并CS患者的基线特征、血管造影、超声心动图和实验室参数对院内死亡的预测价值。患者在其索引住院期间被分为存活者和非存活者两组。
研究人群的死亡率为61.3%。在对单变量分析中检测到的参数进行调整后的多变量分析中，慢性肾功能衰竭、经皮冠状动脉介入治疗（PCI）后心肌梗死溶栓（TIMI）评分≤2、血糖和乳酸水平、血尿素氮水平、三尖瓣环平面收缩期位移（TAPSE）和射血分数是院内死亡的独立预测因素。
除血流动力学恶化外，血管造影、超声心动图和实验室参数对STEMI合并CS患者的院内死亡有影响。
