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Primary PCI in Patients Admitted with Cardiogenic Shock and STEMI: Outcome and Predictors of In-hospital Mortality

Received: 4 December 2021    Accepted: 27 December 2021    Published: 20 January 2022
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Abstract

Background: It is a well-known phenomenon that cardiogenic shock (CS) is a serious complication of acute myocardial infarction. The mortality rate is approximately 50% even with rapid revascularization, optimal medical care, and use of mechanical support. Aim of the Work: To investigate the outcome of primary percutaneous coronary intervention (PCI) in patients admitted with cardiogenic shock and ST-segment elevation myocardial infarction (STEMI) and the predictors of in-hospital mortality. Patients and Methods: This prospective, observational study was conducted in the national heart Institute, Alazhar University, and Military hospitals in the period from 6/2019 to 9/2021 on fifty six consecutive patients presenting to Alazhar University hospitals, National Heart Institute (NHI), Military hospitals. Results: The prevalence of dyslipidemia and diabetes mellitus were significantly higher among died patients than those who survived. The degree of LV impairment was significantly higher among patients who died than those who survived. As regard to PCI procedure characteristics, TIMI flow post PCI (Conclusion: Multi-vessel coronary artery disease, TIMI flow after PCI (grade III), and ↑ CK-MB (72-hour serial measurement), were all found to be significant predictors of in-hospital mortality. The onset from chest pain to ED arrival and the door-to-balloon time were higher than that reported in the previous studies. The use of IABP was not found to have a significant predictor effect on the different outcome among our patients with STEMI.

Published in Cardiology and Cardiovascular Research (Volume 6, Issue 1)
DOI 10.11648/j.ccr.20220601.12
Page(s) 5-13
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

PPCI, Cardiogenic Shock, ST-elevation, Myocardial Infarction, In-hospital Mortality

References
[1] Thom T, Haase N, Rosamuun W, et al. Heart disease and stroke statistics-2009 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcomittee. Circulation 2009; 113: e85-151.
[2] Buerke M, Lemm H, Dietz S, et al. Pathophysiology, diagnosis, and treatment of infarction-related cardiogenic shock. Herz. 2011; 36 (2): 73-83.
[3] Gilles C, Bachir A, Holger T, et al. Shock in Acute Myocardial Infarction: The Cap Horn for Trials? European Heart Journal 2010; 31 (15): 1828-1835.
[4] Thiele H and Schuler G. Cardiogenic shock: to pump or not to pump? Eur Heart J 2009; 30 (4): 389-390.
[5] Goldberg RJ, Spencer FA, Gore JM, et al. Thirty-year trends (1975 to 2005) in the magnitude of, management of, and hospital death rates associated with cardiogenic shock in patients with acute myocardial infarction: a population-based perspective. Circulation 2009; 119 (9): 1211-1219.
[6] Yoshimori An, Shuichiro Kaji, Kitae Kim, et al. Successful Thrombus Aspiration During Primary Percutaneous Coronary Intervention Reduces Infarct Size and Preserves Myocardial Viability J Invasive Cardiol 2011; 23 (5): 172-176.
[7] Navarese EP, De servi S and Politi A. Impact of primary PCI volume on hospital mortality in STEMI patients: does time-to-presentation matter? J Thromb thrombolysis 2011; 32 (2): 223-31.
[8] John GW, Timothy AS, Harvey DW, et al. Percutaneous coronary interventionfor cardiogenic shock in the SHOCK trial (Should we emergently revascularized Occluded coronaries for cardiogenic shock?). Journal of American college of cardiology 2003; 42 (8): 1380–1386.
[9] Gabriel F, Noel T, Accoceberry I. Lindnera (Pichia) fabianii blood infection after mesenteric ischemia. Medical mycology. 2012; 50 (3): 310-4.
[10] Gibson CM, Cannon CP, Murphy SA, et al. Relationship of TIMI myocardial perfusion grade to mortality after administration of thrombolytic drugs. Circulation. 2000; 101 (2): 125-30.
[11] Roberto M, Michelle Bierig and Richard BD et al. Recommendations for Chamber Quantification: A Report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, Developed in Conjunction with the European Association of Echocardiography, a Branch of the European Society of Cardiology. J Am Soc Echocardiogr 2005; 18 (12): 1440-1463.
[12] Cerqueira MD, Weissman NJ, Dilsizian V, et al. Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart: a statement for healthcare professionals from the cardiac imaging committee of the council on clinical cardiology of the American Heart Association. Circulation 2002; 105 (4): 539-42.
[13] Mendis S, Thygesen K, Kuulasmaa K, Giampaoli S, Mähönen M, Ngu Blackett K, Lisheng L, Writing group on behalf of the participating experts of the WHO consultation for revision of WHO definition of myocardial infarction. World Health Organization definition of myocardial infarction: 2008–09 revision. International journal of epidemiology. 2011; 40 (1): 139-46.
[14] Kristian T, Joseph A, Allan J, et al. the Writing Group on behalf of the Joint ESC/ACCF/AHA/WHF Task Force for the Universal Definition of Myocardial Infarction. 2012; 125 (21): 2613-20.
[15] Kinnaird T, Strabile E, Mintz G. et al. Incidence, predictors, and prognostic implications of bleeding and blood transfusion following percutaneous coronary intervention. Am J Cardiol 2003; 92 (8), 930-935.
[16] Lakhal K, Ehrmann S, Chaari A, et al. Acute Kidney Injury Network definition of contrast-induced nephropathy in the critically ill: incidence and outcome. J Crit Care 2011; (6): 593-9.
[17] Langlotz CP. Fundamental measures of diagnostic examination performance: usefulness for clinical decision making and research. Radiology 2003; 228 (1): 3-9.
[18] Mehmet E, Hüseyin U, Emre A, et al. Primary percutaneous coronary intervention in patients admitted with cardiogenic shock and ST-elevation myocardial infarction: prognosis and predictors of in-hospital mortality. Arch Turk Soc Cardiol 2010; 38 (4): 250-257.
[19] Arun M, Laxman D, Yadab B, et al. Primary Percutaneous Coronary Intervention (PPCI) in acute myocardial infarction complicated with cardiogenic shock in a newly emerging cardiac center in Nepal. J Res Med Sci. 2009; 14 (2): 123–127.
[20] Ayaz H, Bashir H, Asad P, et al. Primary Percutaneous Coronary Intervention for ST elevation myocardial infarction complicated by Cardiogenic Shock. JPMA 2013; 63 (6): 490-495.
[21] Francesco D, Elena G, Rosario Fi, et al. One-Year Clinical Outcome of Elderly Patients Undergoing Angioplasty for ST-Elevation Myocardial Infarction Complicated by Cardiogenic Shock: The Importance of 3-Vessel Disease and Final TIMI-3 Flow Grade. J Invasive Cardiol 2014; 26 (3): 114-118.
[22] Silber S, Albertsson P, Avilés F et al. Guidelines for percutaneous coronary interventions. The Task Force for Percutaneous Coronary Interventions of the European Society of Cardiology. Eur Heart J 2005; 26 (8): 804-47.
[23] Etienne P, Tabassome S, Denis A, et al. Long-term outcome in early survivors of cardiogenic shock at the acute stage of myocardial infarction: a landmark analysis from the French registry of Acute ST-elevation and non-ST-elevation Myocardial Infarction (FAST-MI) Registry. Critical Care 2014, 18 (5): 516-20.
Cite This Article
  • APA Style

    Samir Mostafa Kotb Hatem, Mohamed Elsayed Abderhman, Ahmed Abdelhameed Rozza, Mostafa Mokarrab. (2022). Primary PCI in Patients Admitted with Cardiogenic Shock and STEMI: Outcome and Predictors of In-hospital Mortality. Cardiology and Cardiovascular Research, 6(1), 5-13. https://doi.org/10.11648/j.ccr.20220601.12

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    ACS Style

    Samir Mostafa Kotb Hatem; Mohamed Elsayed Abderhman; Ahmed Abdelhameed Rozza; Mostafa Mokarrab. Primary PCI in Patients Admitted with Cardiogenic Shock and STEMI: Outcome and Predictors of In-hospital Mortality. Cardiol. Cardiovasc. Res. 2022, 6(1), 5-13. doi: 10.11648/j.ccr.20220601.12

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    AMA Style

    Samir Mostafa Kotb Hatem, Mohamed Elsayed Abderhman, Ahmed Abdelhameed Rozza, Mostafa Mokarrab. Primary PCI in Patients Admitted with Cardiogenic Shock and STEMI: Outcome and Predictors of In-hospital Mortality. Cardiol Cardiovasc Res. 2022;6(1):5-13. doi: 10.11648/j.ccr.20220601.12

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  • @article{10.11648/j.ccr.20220601.12,
      author = {Samir Mostafa Kotb Hatem and Mohamed Elsayed Abderhman and Ahmed Abdelhameed Rozza and Mostafa Mokarrab},
      title = {Primary PCI in Patients Admitted with Cardiogenic Shock and STEMI: Outcome and Predictors of In-hospital Mortality},
      journal = {Cardiology and Cardiovascular Research},
      volume = {6},
      number = {1},
      pages = {5-13},
      doi = {10.11648/j.ccr.20220601.12},
      url = {https://doi.org/10.11648/j.ccr.20220601.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ccr.20220601.12},
      abstract = {Background: It is a well-known phenomenon that cardiogenic shock (CS) is a serious complication of acute myocardial infarction. The mortality rate is approximately 50% even with rapid revascularization, optimal medical care, and use of mechanical support. Aim of the Work: To investigate the outcome of primary percutaneous coronary intervention (PCI) in patients admitted with cardiogenic shock and ST-segment elevation myocardial infarction (STEMI) and the predictors of in-hospital mortality. Patients and Methods: This prospective, observational study was conducted in the national heart Institute, Alazhar University, and Military hospitals in the period from 6/2019 to 9/2021 on fifty six consecutive patients presenting to Alazhar University hospitals, National Heart Institute (NHI), Military hospitals. Results: The prevalence of dyslipidemia and diabetes mellitus were significantly higher among died patients than those who survived. The degree of LV impairment was significantly higher among patients who died than those who survived. As regard to PCI procedure characteristics, TIMI flow post PCI (Conclusion: Multi-vessel coronary artery disease, TIMI flow after PCI (grade III), and ↑ CK-MB (72-hour serial measurement), were all found to be significant predictors of in-hospital mortality. The onset from chest pain to ED arrival and the door-to-balloon time were higher than that reported in the previous studies. The use of IABP was not found to have a significant predictor effect on the different outcome among our patients with STEMI.},
     year = {2022}
    }
    

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  • TY  - JOUR
    T1  - Primary PCI in Patients Admitted with Cardiogenic Shock and STEMI: Outcome and Predictors of In-hospital Mortality
    AU  - Samir Mostafa Kotb Hatem
    AU  - Mohamed Elsayed Abderhman
    AU  - Ahmed Abdelhameed Rozza
    AU  - Mostafa Mokarrab
    Y1  - 2022/01/20
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    N1  - https://doi.org/10.11648/j.ccr.20220601.12
    DO  - 10.11648/j.ccr.20220601.12
    T2  - Cardiology and Cardiovascular Research
    JF  - Cardiology and Cardiovascular Research
    JO  - Cardiology and Cardiovascular Research
    SP  - 5
    EP  - 13
    PB  - Science Publishing Group
    SN  - 2578-8914
    UR  - https://doi.org/10.11648/j.ccr.20220601.12
    AB  - Background: It is a well-known phenomenon that cardiogenic shock (CS) is a serious complication of acute myocardial infarction. The mortality rate is approximately 50% even with rapid revascularization, optimal medical care, and use of mechanical support. Aim of the Work: To investigate the outcome of primary percutaneous coronary intervention (PCI) in patients admitted with cardiogenic shock and ST-segment elevation myocardial infarction (STEMI) and the predictors of in-hospital mortality. Patients and Methods: This prospective, observational study was conducted in the national heart Institute, Alazhar University, and Military hospitals in the period from 6/2019 to 9/2021 on fifty six consecutive patients presenting to Alazhar University hospitals, National Heart Institute (NHI), Military hospitals. Results: The prevalence of dyslipidemia and diabetes mellitus were significantly higher among died patients than those who survived. The degree of LV impairment was significantly higher among patients who died than those who survived. As regard to PCI procedure characteristics, TIMI flow post PCI (Conclusion: Multi-vessel coronary artery disease, TIMI flow after PCI (grade III), and ↑ CK-MB (72-hour serial measurement), were all found to be significant predictors of in-hospital mortality. The onset from chest pain to ED arrival and the door-to-balloon time were higher than that reported in the previous studies. The use of IABP was not found to have a significant predictor effect on the different outcome among our patients with STEMI.
    VL  - 6
    IS  - 1
    ER  - 

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Author Information
  • Department of Emergency, Faculty of Medicine, Cairo University, Cairo, Egypt

  • Department of Cardiology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

  • Department of Emergency, Faculty of Medicine, Cairo University, Cairo, Egypt

  • Department of Emergency, Faculty of Medicine, Cairo University, Cairo, Egypt

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