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

IF 0.2 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pakistan Heart Journal Pub Date : 2023-06-29 DOI:10.47144/phj.v56i2.2578
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
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引用次数: 0

摘要

目的:本研究的目的是调查接受直接经皮冠状动脉介入治疗(PCI)的ST段抬高型心肌梗死(STEMI)并发心源性休克(CS)患者的即时和短期死亡率。方法:本观察性研究在巴基斯坦的一家三级护理心脏中心进行。我们纳入了连续的被诊断为STEMI并发CS的患者,他们接受了初次PCI。我们分析了患者的临床特征、管理策略、住院情况以及短期随访结果。结果:共有200名患者被纳入研究,其中74.5%(149)为男性,平均年龄为57.96±12.52岁。大多数患者被归类为Killip III级(64.0%128),其余患者被归类于Killip IV级。抵达时,37.5%(75)的患者出现心律失常,27.5%(55)的患者处于心脏骤停状态,84.5%(169)的患者需要插管。31.5%(63)的患者进行了主动脉内球囊泵(IABP)植入,18.5%(37)的患者放置了临时起搏器(TPM)。住院死亡率为10.5%(21)。在177天(141.5-212.5)的平均随访期内,48%(96)的患者出现了累积性重大心血管不良事件(MACE),全因死亡率为28%(56)。此外,7.5%(15)的患者再次发生梗死,23.5%(47)的患者因心力衰竭再次住院。结论:我们的研究显示CS患者经皮冠状动脉介入治疗后的住院死亡率为10.5%。在急性事件发生后约6个月,近一半的患者出现MACE,显著的死亡率为28%。这些发现突出了CS的关键性,并强调了进一步研究和干预的必要性,以改善这一高风险患者群体的结果。
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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.
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来源期刊
Pakistan Heart Journal
Pakistan Heart Journal CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
0.20
自引率
0.00%
发文量
64
审稿时长
6 weeks
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