Rajesh Kumar, K. Khan, Kubbra Rahooja, Kalsoom Chachar, Muhammad Qasim Khan, Ahsan T. Ali, Ali Bin Naseer, Abdul Basit, M. Rasool, Uroosa Safdar, Abiha Urooj, A. Hussain, M. Ishaq, Anesh Wadhwa, Fawad Farooq, Sohail Q Khan, J. Sial
{"title":"经皮冠状动脉介入治疗的心源性休克患者st段抬高型心肌梗死的预后","authors":"Rajesh Kumar, K. Khan, Kubbra Rahooja, Kalsoom Chachar, Muhammad Qasim Khan, Ahsan T. Ali, Ali Bin Naseer, Abdul Basit, M. Rasool, Uroosa Safdar, Abiha Urooj, A. Hussain, M. Ishaq, Anesh Wadhwa, Fawad Farooq, Sohail Q Khan, J. Sial","doi":"10.47144/phj.v56i2.2578","DOIUrl":null,"url":null,"abstract":"Objectives: The objective of this study was to investigate the immediate and short-term mortality rates among patients with ST-segment elevation myocardial infarction (STEMI) complicated by cardiogenic shock (CS) who underwent primary percutaneous coronary intervention (PCI). Methodology: This observational study was conducted at a tertiary care cardiac center in Pakistan. We included consecutive patients diagnosed with STEMI complicated by CS who underwent primary PCI. We analyzed the clinical characteristics, management strategies, and in-hospital as well as short-term follow-up outcomes of the patients. Results: A total of 200 patients were included in the study, of which 74.5% (149) were male, and the mean age was 57.96 ± 12.52 years. The majority of patients were classified as Killip class III (64.0%, 128), while the remaining were classified as Killip class IV. On arrival, arrhythmias were observed in 37.5% (75) of the patients, 27.5% (55) were in cardiac arrest and 84.5% (169) required intubation. Intra-aortic balloon pump (IABP) placement was performed in 31.5% (63) of the patients, and temporary pacemakers (TPM) were placed in 18.5% (37). The in-hospital mortality rate was found to be 10.5% (21). During a mean follow-up period of 177 days (141.5-212.5), a cumulative major adverse cardiovascular event (MACE) was observed in 48% (96) of the patients, with an all-cause mortality rate of 28% (56). Additionally, re-infarction occurred in 7.5% (15) of the patients, and re-hospitalization due to heart failure was noted in 23.5% (47) of the patients. Conclusion: Our study revealed an in-hospital mortality rate of 10.5% following primary PCI in patients with CS. At approximately six months after the acute event, nearly half of the patients experienced MACE, with a notable mortality rate of 28%. These findings highlight the critical nature of CS and emphasize the need for further research and interventions to improve outcomes in this high-risk patient population.","PeriodicalId":42273,"journal":{"name":"Pakistan Heart Journal","volume":null,"pages":null},"PeriodicalIF":0.2000,"publicationDate":"2023-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Outcomes of ST-Segment Elevation Myocardial Infarction in a Cohort of Cardiogenic Shock Patients Undergoing Primary Percutaneous Coronary Intervention\",\"authors\":\"Rajesh Kumar, K. Khan, Kubbra Rahooja, Kalsoom Chachar, Muhammad Qasim Khan, Ahsan T. Ali, Ali Bin Naseer, Abdul Basit, M. Rasool, Uroosa Safdar, Abiha Urooj, A. Hussain, M. Ishaq, Anesh Wadhwa, Fawad Farooq, Sohail Q Khan, J. Sial\",\"doi\":\"10.47144/phj.v56i2.2578\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Objectives: The objective of this study was to investigate the immediate and short-term mortality rates among patients with ST-segment elevation myocardial infarction (STEMI) complicated by cardiogenic shock (CS) who underwent primary percutaneous coronary intervention (PCI). Methodology: This observational study was conducted at a tertiary care cardiac center in Pakistan. We included consecutive patients diagnosed with STEMI complicated by CS who underwent primary PCI. We analyzed the clinical characteristics, management strategies, and in-hospital as well as short-term follow-up outcomes of the patients. Results: A total of 200 patients were included in the study, of which 74.5% (149) were male, and the mean age was 57.96 ± 12.52 years. The majority of patients were classified as Killip class III (64.0%, 128), while the remaining were classified as Killip class IV. On arrival, arrhythmias were observed in 37.5% (75) of the patients, 27.5% (55) were in cardiac arrest and 84.5% (169) required intubation. Intra-aortic balloon pump (IABP) placement was performed in 31.5% (63) of the patients, and temporary pacemakers (TPM) were placed in 18.5% (37). The in-hospital mortality rate was found to be 10.5% (21). During a mean follow-up period of 177 days (141.5-212.5), a cumulative major adverse cardiovascular event (MACE) was observed in 48% (96) of the patients, with an all-cause mortality rate of 28% (56). Additionally, re-infarction occurred in 7.5% (15) of the patients, and re-hospitalization due to heart failure was noted in 23.5% (47) of the patients. Conclusion: Our study revealed an in-hospital mortality rate of 10.5% following primary PCI in patients with CS. At approximately six months after the acute event, nearly half of the patients experienced MACE, with a notable mortality rate of 28%. These findings highlight the critical nature of CS and emphasize the need for further research and interventions to improve outcomes in this high-risk patient population.\",\"PeriodicalId\":42273,\"journal\":{\"name\":\"Pakistan Heart Journal\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.2000,\"publicationDate\":\"2023-06-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Pakistan Heart Journal\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.47144/phj.v56i2.2578\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pakistan Heart Journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.47144/phj.v56i2.2578","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Outcomes of ST-Segment Elevation Myocardial Infarction in a Cohort of Cardiogenic Shock Patients Undergoing Primary Percutaneous Coronary Intervention
Objectives: The objective of this study was to investigate the immediate and short-term mortality rates among patients with ST-segment elevation myocardial infarction (STEMI) complicated by cardiogenic shock (CS) who underwent primary percutaneous coronary intervention (PCI). Methodology: This observational study was conducted at a tertiary care cardiac center in Pakistan. We included consecutive patients diagnosed with STEMI complicated by CS who underwent primary PCI. We analyzed the clinical characteristics, management strategies, and in-hospital as well as short-term follow-up outcomes of the patients. Results: A total of 200 patients were included in the study, of which 74.5% (149) were male, and the mean age was 57.96 ± 12.52 years. The majority of patients were classified as Killip class III (64.0%, 128), while the remaining were classified as Killip class IV. On arrival, arrhythmias were observed in 37.5% (75) of the patients, 27.5% (55) were in cardiac arrest and 84.5% (169) required intubation. Intra-aortic balloon pump (IABP) placement was performed in 31.5% (63) of the patients, and temporary pacemakers (TPM) were placed in 18.5% (37). The in-hospital mortality rate was found to be 10.5% (21). During a mean follow-up period of 177 days (141.5-212.5), a cumulative major adverse cardiovascular event (MACE) was observed in 48% (96) of the patients, with an all-cause mortality rate of 28% (56). Additionally, re-infarction occurred in 7.5% (15) of the patients, and re-hospitalization due to heart failure was noted in 23.5% (47) of the patients. Conclusion: Our study revealed an in-hospital mortality rate of 10.5% following primary PCI in patients with CS. At approximately six months after the acute event, nearly half of the patients experienced MACE, with a notable mortality rate of 28%. These findings highlight the critical nature of CS and emphasize the need for further research and interventions to improve outcomes in this high-risk patient population.