Please use this identifier to cite or link to this item:
Title: Outcomes of cardiogenic shock complicating acute coronary syndromes.
Author: Noaman, Samer
Andrianopoulos, Nick
Brennan, Angela
Dinh, Diem
Reid, Christopher
Stub, Dion
Biswas, Sinjini
Clark, David
Shaw, James
Ajani, Andrew
Freeman, Melanie
Yip, Thomas
Oqueli, Ernesto
Walton, Antony
Duffy, Stephen
Chan, William
on behalf of the Melbourne Interventional Group Investigators
Issue Date: 2020
Publication Title: Catheterization & Cardiovascular Interventions
Volume: 96
Issue: 3
Start Page: e257
End Page: e267
Abstract: Objectives We aimed to assess the outcomes of cardiogenic shock (CS) complicating acute coronary syndromes (ACS). Background CS remains the leading cause of mortality in patients presenting with ACS despite advances in care. Methods We studied 13,184 patients undergoing percutaneous coronary intervention (PCI) for all subtypes of ACS enrolled prospectively in a large multicentre Australian registry (Melbourne Interventional Group registry) from 2005 to 2013. All‐cause mortality was obtained via linkage to the National Death Index. Patients were divided into those with and those without CS. Results Compared to the non‐CS group (n = 12,548, 95.2%), the CS group (n = 636, 4.8%) had a higher proportion of out‐of‐hospital cardiac arrest (OHCA) (31.1 vs. 2.2%) and ST‐elevation myocardial infarction (STEMI) presentation (89 vs. 34%), both p < .01. Patients in the CS group had higher rates of in‐hospital (40.4 vs. 1.2%) and 30‐day (41 vs. 1.7%) mortality compared to the non‐CS group. Long‐term mortality over a median follow‐up of 4.2 years was higher in the CS group (50.6 vs. 13.8%), p < .001. Trends of in‐hospital and 30‐day mortality rates of CS complicating ACS were relatively stable from 2005 to 2013. Predictors of long‐term NDI‐linked mortality within the CS group include severe left ventricular systolic dysfunction (HR 3.0), glomerular filtration rate (GFR) <30 (HR 2.56), GFR 30–59 (HR 1.94), OHCA (HR 1.46), diabetes (HR 1.44), and age (HR 1.02), all p < .05. Conclusions Rates of CS‐related mortality complicating ACS have remained very high and steady over nearly a decade despite progress in STEMI systems of care, PCI techniques, and medical therapy.
Internal ID Number: 01562
Type: Journal Article
Appears in Collections:Research Output

Files in This Item:
There are no files associated with this item.

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.