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拉丁美洲急性冠状动脉综合征相关心原性休克(“LATIN Shock”)。

Cardiogenic shock in the context of acute coronary syndromes in Latin America ("LATIN Shock").

机构信息

Sociedad Argentina de Cardiología.

Clínica Santa Isabel, Buenos Aires, Argentina.

出版信息

Curr Probl Cardiol. 2024 Oct;49(10):102745. doi: 10.1016/j.cpcardiol.2024.102745. Epub 2024 Aug 10.

Abstract

UNLABELLED

Cardiogenic shock (CS) is a serious complication of heart attack and constitutes one of its main causes of death. To date, there is no data on its treatment and evolution in Latin America.

OBJECTIVES

To know the clinical characteristics, treatment strategies, evolution and in-hospital mortality of CS in Latin America.

MATERIALS AND METHODS

This is a prospective, multicenter registry of patients hospitalized with CS in the context of acute coronary syndromes (ACS) with and without ST segment elevation for 24 months.

RESULTS

41 Latin American centers participated incorporating patients during the period between October 2021 and September 2023. 278 patients were included. Age: 66 (59-75) years, 70.1 % men. 74.8 % of the cases correspond to ACS with ST elevation, 14.4 % to ACS without ST elevation, 5.7 % to right ventricular infarction and 5.1 % to mechanical complications. CS was present from admission in 60 % of cases. Revascularization: 81.3 %, inotropic use: 97.8 %, ARM: 52.5 %, Swan Ganz: 17 %, intra-aortic balloon pump: 22.2 %. Overall in-hospital mortality was 52.7 %, with no differences between ACS with or without ST.

CONCLUSIONS

Morbidity and mortality is very high despite the high reperfusion used.

摘要

背景

心原性休克(CS)是心脏病发作的严重并发症,也是其主要死亡原因之一。迄今为止,拉丁美洲尚无关于其治疗和演变的数据。

目的

了解拉丁美洲 CS 的临床特征、治疗策略、演变和院内死亡率。

材料和方法

这是一项前瞻性、多中心登记研究,纳入了在急性冠状动脉综合征(ACS)背景下住院的 CS 患者,包括伴或不伴 ST 段抬高的 ACS 患者,随访时间为 24 个月。

结果

41 个拉丁美洲中心参与了该研究,在 2021 年 10 月至 2023 年 9 月期间纳入了患者。共纳入 278 例患者。年龄:66(59-75)岁,70.1%为男性。74.8%的病例为 ST 段抬高型 ACS,14.4%为非 ST 段抬高型 ACS,5.7%为右心室梗死,5.1%为机械并发症。60%的患者入院时即存在 CS。血运重建:81.3%,正性肌力药物应用:97.8%,主动脉球囊反搏(ARM):52.5%, Swan-Ganz 导管:17%,主动脉内球囊泵(IABP):22.2%。总的院内死亡率为 52.7%,ST 段抬高型 ACS 和非 ST 段抬高型 ACS 之间无差异。

结论

尽管采用了高再灌注,但发病率和死亡率仍非常高。

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