Kasahara Taku, Sakakura Kenichi, Hori Nanase, Jinnouchi Hiroyuki, Taniguchi Yousuke, Tsukui Takunori, Watanabe Yusuke, Yamamoto Kei, Seguchi Masaru, Wada Hiroshi, Fujita Hideo
Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma, Omiya, Saitama City, 330-8503, Japan.
Heart Vessels. 2023 Feb;38(2):139-146. doi: 10.1007/s00380-022-02145-5. Epub 2022 Jul 29.
In-hospital mortality of acute myocardial infarction (AMI) complicated with cardiogenic shock (CS) remains high. Also, in-hospital mortality of AMI complicated with cardiac arrest (CA) has been reported to be highest among any AMI. However, there were few reports that compared in-hospital mortality directly between AMI complicated with CS and complicated with CA. The purpose of this study was to compare in-hospital outcomes between AMI complicated with CS and complicated with CA. We retrospectively included 195 AMI patients complicated by CS or CA, and divided those into the CA group (n = 109) and the CS group (n = 86). We also subdivided the CA group into CA with persistent CS (n = 83) and CA without persistent CS (n = 26). One-third of the study population died during the index admission. In-hospital death was more frequently observed in the CA group (45.0%) than in the CS group (20.9%) (p < 0.001). In-hospital mortality was highest in the CA with persistent CS group (68.7%), followed by the CS group (20.9%), and least in the CA without persistent CS group (11.5%) (p < 0.001). Favorable neurological function was more frequently observed in the CA without persistent CS group (76.9%) and the CS group (74.4%) than in the CA with persistent CS group (27.7%) (p < 0.001). In conclusion, in-hospital mortality was higher in AMI patients with CA than in those with CS. However, when we divided AMI patients with CA into those with and without persistent CS, in-hospital mortality was lowest in CA without persistent CS, followed by CS, and highest in CA with persistent CS.
急性心肌梗死（AMI）合并心源性休克（CS）患者的院内死亡率仍然很高。此外，据报道，AMI合并心脏骤停（CA）患者的院内死亡率在所有AMI患者中是最高的。然而，很少有报告直接比较AMI合并CS和合并CA患者的院内死亡率。本研究的目的是比较AMI合并CS和合并CA患者的院内结局。我们回顾性纳入了195例合并CS或CA的AMI患者，并将其分为CA组（n = 109）和CS组（n = 86）。我们还将CA组细分为伴有持续性CS的CA组（n = 83）和不伴有持续性CS的CA组（n = 26）。三分之一的研究人群在本次住院期间死亡。CA组（45.0%）的院内死亡发生率高于CS组（20.9%）（p < 0.001）。伴有持续性CS的CA组院内死亡率最高（68.7%），其次是CS组（20.9%），最低的是不伴有持续性CS的CA组（11.5%）（p < 0.001）。不伴有持续性CS的CA组（76.9%）和CS组（74.4%）的神经功能良好发生率高于伴有持续性CS的CA组（27.7%）（p < 0.001）。总之，AMI合并CA患者的院内死亡率高于合并CS的患者。然而，当我们将AMI合并CA的患者分为伴有和不伴有持续性CS的患者时，不伴有持续性CS的CA组院内死亡率最低，其次是CS组，伴有持续性CS的CA组最高。
