Liu Shao-Shuai, Wang Juan, Tan Hui-Qiong, Yang Yan-Min, Zhu Jun
Department of Cardiology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, 758 Hefei Road, Qingdao, Shandong, 266035, China.
Emergency Center, Fuwai Hospital, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100037, China.
Heliyon. 2024 Jul 6;10(13):e34070. doi: 10.1016/j.heliyon.2024.e34070. eCollection 2024 Jul 15.
Data on the effect of cardiac arrest (CA), cardiogenic shock (CS), and their combination on the prognosis of Chinese patients with ST-segment elevation myocardial infarction (STEMI) are limited. The present study sought to evaluate the clinical outcomes of STEMI complicated by CA and CS, and to identify the risk factors for CA or CS.
This study included 7468 consecutive patients with STEMI in China. The patients were divided into 4 groups (CA + CS, CA only, CS only, and No CA or CS). The endpoints were 30-day all-cause death and major adverse cardiovascular events. A Cox proportional hazards regression analysis was performed.
CA, CS, and their combination were noted in 332 (4.4 %), 377 (5.0 %), and 117 (1.6 %) among all patients. During the 30-day follow-up, 817 (10.9 %) all-cause deaths and 964 (12.9 %) major adverse cardiovascular events occurred, and the incidence of all-cause mortality (3.6 %, 62.3 %, 74.1 %, 83.3 %) and major adverse cardiovascular events (5.4 %, 67.1 %, 75.0 %, and 87.2 %) significantly increased in the No CA or CS, CS only, CA only, and CA + CS groups, respectively. In the multivariate Cox regression models, compared with the No CA or CS group, the CA + CS, CA, and S-only groups were associated with an increased risk of all-cause death and major adverse cardiovascular events. Patients with CA + CS had the highest risk of all-cause death (hazard ratio [HR], 25.259 [95 % confidence interval (CI) 19.221-33.195]) and major adverse cardiovascular events (HR 19.098, 95%CI 14.797-24.648).
CA, CS, and their combination were observed in approximately 11 % of Chinese patients with STEMI, and were associated with increased risk for 30-day mortality and major adverse cardiovascular events in Chinese patients with STEMI.
关于心脏骤停（CA）、心源性休克（CS）及其联合情况对中国ST段抬高型心肌梗死（STEMI）患者预后影响的数据有限。本研究旨在评估STEMI合并CA和CS的临床结局，并确定发生CA或CS的危险因素。
本研究纳入了中国7468例连续的STEMI患者。患者被分为4组（CA + CS、仅CA、仅CS以及无CA或CS）。终点为30天全因死亡和主要不良心血管事件。进行了Cox比例风险回归分析。
在所有患者中，CA、CS及其联合情况分别见于332例（4.4%）、377例（5.0%）和117例（1.6%）。在30天随访期间，发生了817例（10.9%）全因死亡和964例（12.9%）主要不良心血管事件，全因死亡率（3.6%、62.3%、74.1%、83.3%）和主要不良心血管事件发生率（5.4%、67.1%、75.0%、87.2%）在无CA或CS、仅CS、仅CA以及CA + CS组中分别显著增加。在多变量Cox回归模型中，与无CA或CS组相比，CA + CS、CA和仅CS组全因死亡和主要不良心血管事件风险增加。CA + CS患者全因死亡风险最高（风险比[HR]，25.259[95%置信区间（CI）19.221 - 33.195]）和主要不良心血管事件风险最高（HR 19.098，95%CI 14.797 - 24.648）。
在中国STEMI患者中，约11%观察到CA、CS及其联合情况，并且与中国STEMI患者30天死亡率和主要不良心血管事件风险增加相关。
