Peters Elma J, Berg Sanne Ten, Bogerd Margriet, Timmermans Marijke J C, Kraaijeveld Adriaan O, Bunge Jeroen J H, Teeuwen Koen, Lipsic Erik, Sjauw Krischan D, Geuns Robert-Jan M van, Dedic Admir, Dubois Eric A, Meuwissen Martijn, Danse Peter, Verouden Niels J W, Bleeker Gabe, Cabezas José M Montero, Ferreira Irlando A, Engström Annemarie E, Lagrand Wim K, Otterspoor Luuk C, Vlaar Alexander P J, Henriques José P S
Heart Center, Department of Cardiology, Amsterdam University Medical Centers, 1105 AZ Amsterdam, The Netherlands.
Netherlands Heart Registration, 3511 EP Utrecht, The Netherlands.
J Clin Med. 2023 Aug 10;12(16):5221. doi: 10.3390/jcm12165221.
Cardiogenic shock (CS) complicating acute myocardial infarction (AMI) is associated with high morbidity and mortality. Our study aimed to gain insights into patient characteristics, outcomes and treatment strategies in CS patients. Patients with CS who underwent percutaneous coronary intervention (PCI) between 2017 and 2021 were identified in a nationwide registry. Data on medical history, laboratory values, angiographic features and outcomes were retrospectively assessed. A total of 2328 patients with a mean age of 66 years and of whom 73% were male, were included. Mortality at 30 days was 39% for the entire cohort. Non-survivors presented with a lower mean blood pressure and increased heart rate, blood lactate and blood glucose levels (-value for all <0.001). Also, an increased prevalence of diabetes, multivessel coronary artery disease and a prior coronary event were found. Of all patients, 24% received mechanical circulatory support, of which the majority was via intra-aortic balloon pumps (IABPs). Furthermore, 79% of patients were treated with at least one vasoactive agent, and multivessel PCI was performed in 28%. In conclusion, a large set of hemodynamic, biochemical and patient-related characteristics was identified to be associated with mortality. Interestingly, multivessel PCI and IABPs were frequently applied despite a lack of evidence.
心源性休克（CS）并发急性心肌梗死（AMI）与高发病率和死亡率相关。我们的研究旨在深入了解CS患者的特征、预后和治疗策略。在一项全国性登记研究中，纳入了2017年至2021年间接受经皮冠状动脉介入治疗（PCI）的CS患者。回顾性评估患者的病史、实验室检查值、血管造影特征和预后。共纳入2328例患者，平均年龄66岁，其中73%为男性。整个队列30天死亡率为39%。非幸存者的平均血压较低，心率、血乳酸和血糖水平升高（所有P值均<0.001）。此外，还发现糖尿病、多支冠状动脉疾病和既往冠状动脉事件的患病率增加。所有患者中，24%接受了机械循环支持，其中大多数通过主动脉内球囊反搏（IABP）进行。此外，79%的患者接受了至少一种血管活性药物治疗，28%的患者接受了多支血管PCI治疗。总之，大量血流动力学、生化和患者相关特征被确定与死亡率相关。有趣的是，尽管缺乏证据，多支血管PCI和IABP仍经常应用。
