Jung Sodam, Jang Woo Jin, Lee Wang Soo, Park Ik Hyun, Oh Ju Hyeon, Yang Jeong Hoon, Gwon Hyeon-Cheol, Ahn Chul-Min, Yu Cheol Woong, Kim Hyun-Joong, Bae Jang-Whan, Kwon Sung Uk, Lee Hyun-Jong, Jeong Jin-Ok, Park Sang-Don
Department of Cardiology, Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea.
Division of Cardiology, Department of Internal Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Republic of Korea.
Heliyon. 2024 Apr 24;10(9):e30078. doi: 10.1016/j.heliyon.2024.e30078. eCollection 2024 May 15.
Little is known about the association between seasonal variation and prognosis in patients with CS caused by AMI.
We investigated the 12-month clinical outcomes in patients treated with percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) complicated by cardiogenic shock (CS) according to season.
A total of 695 patients undergoing PCI for AMI complicated by CS was enrolled from 12 centers in South Korea. The study patients were divided into four groups according to season in which the AMI with CS occurred (spring, n = 178 vs. summer, n = 155 vs. autumn, n = 182 vs. winter, n = 180). We compared major adverse cardiovascular events (MACEs; the composite of cardiac death, myocardial infarction, re-hospitalization due to heart failure, and any revascularization) between the four groups.
The risk of MACE during the 12 months after CS was similar in the four groups: spring, 68 patients, vs. summer, 69, vs. autumn, 73, vs. winter, 68 ( = 0.587). Multivariate Cox-regression analysis revealed no significant difference in 12-month MACE among groups compared to the spring group after inverse probability of treatment weighting adjustment (summer, HR 1.40, 95 % CI 0.98-1.99, = 0.062; autumn, HR 1.26, 95 % CI 0.89-1.80, = 0.193; winter, HR 1.18, 95 % CI 0.83-1.67, = 0.356). The similarity of MACE between the four groups was consistent across a variety of subgroups.
After adjusting for baseline differences, seasonal variation seems not to influence the mid-term risk of 12-month MACE in patients treated with PCI for AMI complicated by CS.
Data are limited regarding the association between seasonal variation and prognosis in patients with cardiogenic shock (CS) caused by AMI. This study divided patients undergoing PCI for AMI complicated by CS into four groups based on the season of occurrence and found no significant differences in 12-month MACE between the groups after adjusting for bias and confounding factors. Multivariate analysis revealed consistent MACE similarity across subgroups. The study suggests that seasonal variation has no impact on the mid-term risk of 12-month MACE in patients with CS caused by AMI, after adjusting for baseline differences.
ClinicalTrials.gov NCT02985008RESCUE (REtrospective and prospective observational Study to investigate Clinical oUtcomes and Efficacy of left ventricular assist device for Korean patients with cardiogenic shock), NCT02985008, Registered December 5, 2016 - retrospectively and prospectively.
This study was approved by the institutional review board of Samsung Medical Center (Reference number: 2016-03-130).
关于急性心肌梗死（AMI）所致心源性休克（CS）患者的季节变化与预后之间的关联，目前所知甚少。
我们根据季节调查了接受经皮冠状动脉介入治疗（PCI）的急性心肌梗死（AMI）合并心源性休克（CS）患者的12个月临床结局。
从韩国12个中心招募了总共695例接受PCI治疗AMI合并CS的患者。根据发生AMI合并CS的季节，将研究患者分为四组（春季，n = 178；夏季，n = 155；秋季，n = 182；冬季，n = 180）。我们比较了四组之间的主要不良心血管事件（MACE；心脏性死亡、心肌梗死、因心力衰竭再次住院以及任何血管重建的综合）。
CS后12个月内MACE的风险在四组中相似：春季68例，夏季69例，秋季73例，冬季68例（P = 0.587）。多因素Cox回归分析显示，在进行治疗权重逆概率调整后，与春季组相比，各组之间12个月MACE无显著差异（夏季，HR 1.40，95%CI 0.98 - 1.99，P = 0.062；秋季，HR 1.26，95%CI 0.89 - 1.80，P = 0.193；冬季，HR 1.18，95%CI 0.83 - 1.67，P = 0.356）。四组之间MACE的相似性在各种亚组中均一致。
在调整基线差异后，季节变化似乎不会影响接受PCI治疗的AMI合并CS患者12个月MACE的中期风险。
关于急性心肌梗死（AMI）所致心源性休克（CS）患者的季节变化与预后之间的关联，数据有限。本研究将接受PCI治疗AMI合并CS的患者按发病季节分为四组，在调整偏倚和混杂因素后，发现各组之间12个月MACE无显著差异。多因素分析显示各亚组之间MACE相似性一致。该研究表明，在调整基线差异后，季节变化对AMI所致CS患者12个月MACE的中期风险无影响。
ClinicalTrials.gov NCT02985008RESCUE（调查韩国心源性休克患者左心室辅助装置的临床结局和疗效的回顾性和前瞻性观察研究），NCT02985008，2016年12月5日注册——回顾性和前瞻性。
本研究经三星医疗中心机构审查委员会批准（参考编号：2016 - 03 - 130）。
