Predictors of mortality in patients with cardiogenic shock treated with primary percutaneous coronary intervention and intra-aortic balloon counterpulsation

Schwarz, Bettina; Abdel‐Wahab, Mohamed; Robinson, Derek; Richardt, Gert

doi:10.1007/s00063-015-0118-8

Cited by 15 publications

(18 citation statements)

References 26 publications

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“…The comprehensive search yielded 1093 potentially relevant articles; after exclusion of duplicates and assessment of titles and/or abstracts, 29 articles were chosen for complete review. Finally, nine studies including 1348 patients met our inclusion criteria, published between 2005 and 2017 (Figure S1).…”

Section: Resultsmentioning

confidence: 99%

“…The main characteristics of the included studies are presented in Table 1 and quality assessment results are described in Tables S2 and S3. Seven studies were observational studies, [21][22][23][24][25][26][27] and the remaining two were sub-analysis of randomized controlled trials. 20,28 Five of the eligible studies only enrolled patients who presented with STEMI, [22][23][24][25]27 and the remaining four included patients with non-STEMI.…”

Section: Eligible Studiesmentioning

confidence: 99%

“…20,28 Five of the eligible studies only enrolled patients who presented with STEMI, [22][23][24][25]27 and the remaining four included patients with non-STEMI. 20,21,26,28 Two studies were abstract slides from conference proceedings. Overall, eight studies reported short-term mortality (inhospital and 30-days), [20][21][22][23][24][25][26]28 while four studies reported long-term mortality (≥ 6 months).…”

Section: Eligible Studiesmentioning

confidence: 99%

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Timing of initiation of intra‐aortic balloon pump in patients with acute myocardial infarction complicated by cardiogenic shock: A meta‐analysis

Cui

Lyu

Hong

et al. 2019

Clinical Cardiology

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Background For patients with acute myocardial infarction (AMI) complicated by cardiogenic shock (CS) undergoing primary percutaneous coronary intervention (PCI), the optimal timing of the initiation of intra‐aortic balloon pump (IABP) therapy remains unclear. Therefore, we performed the first meta‐analysis to compare the outcomes of IABP insertion before vs after primary PCI in this population. Methods Electronic databases of PubMed, EMBASE, and Cochrane Library were comprehensively searched from inception to April 1, 2019, to identify the eligible studies. The main outcomes were short‐term (in‐hospital or 30 days) and long‐term (≥ 6 months) mortality. In addition, pooled analysis of risk‐adjusted data were also performed to control for confounding factors. Results Seven observational studies and two sub‐analysis of randomized controlled trials involving 1348 patients were included. Compared to patients inserted IABP after PCI, patients who received IABP therapy before primary PCI had similar risks of short‐term (odds ratio [OR] 0.88, 95% CI 0.49 to 1.59) and long‐term (OR 0.99, 95% CI 0.58 to 1.68) all‐cause mortality. Moreover, a pooled analysis of risk‐adjusted data also found similar effects of the two therapies on short‐term (OR 0.65, 95% CI 0.34 to 1.25) and long‐term (OR 0.68, 95% CI 0.17 to 2.72) mortality. Besides, no significant difference was found between the two groups with respect to reinfarction, repeat revascularization, stroke, renal failure, and major bleeding. Conclusions The timing of the initiation of IABP therapy does not appear to impact short‐term and long‐term survival in patients with AMI complicated by CS undergoing primary PCI.

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Section: Resultsmentioning

confidence: 99%

Section: Eligible Studiesmentioning

confidence: 99%

Section: Eligible Studiesmentioning

confidence: 99%

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Timing of initiation of intra‐aortic balloon pump in patients with acute myocardial infarction complicated by cardiogenic shock: A meta‐analysis

Cui

Lyu

Hong

et al. 2019

Clinical Cardiology

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“…Cardiogenic shock has been shown to represent the most serious complication in STEMI patients [8]. In patients with myocardial infarction and cardiogenic shock, the use of vasopressor agents, age, cardiac arrest, renal failure and counterpulsation balloon insertion, have been proved to represent independent predictors of in-hospital mortality [8,9].…”

Section: Discussionmentioning

confidence: 99%

“…In patients with myocardial infarction and cardiogenic shock, the use of vasopressor agents, age, cardiac arrest, renal failure and counterpulsation balloon insertion, have been proved to represent independent predictors of in-hospital mortality [8,9]. A study reporting on 572 consecutive patients with cardiogenic shock and AMI, indicated that a more severe clinical profile and serious arrhythmia are associated with a higher mortality [9].…”

Section: Discussionmentioning

confidence: 99%

Predictors Of Mortality In Patients With ST-Segment Elevation Acute Myocardial Infarction And Resuscitated Out-Of-Hospital Cardiac Arrest

Barcan

Chițu

Benedek

et al. 2016

The Journal of Critical Care Medicine

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Introduction: In patients with out-of-hospital cardiac arrest (OHCA) complicating an ST-segment elevation myocardial infarction (STEMI), the survival depends largely on the restoration of coronary flow in the infarct related artery. The aim of this study was to determine clinical and angiographic predictors of in-hospital mortality in patients with OHCA and STEMI, successfully resuscitated and undergoing primary percutaneous intervention (PCI). Methods: From January 2013 to July 2015, 78 patients with STEMI presenting OHCA, successfully resuscitated, transferred immediately to the catheterization unit and treated with primary PCI, were analyzed. Clinical, laboratory and angiographic data were compared in 28 non-survivors and 50 survivors. Results:The clinical baseline characteristics of the study population showed no significant differences between the survivors and non-survivors in respect to age (p=0.06), gender (p=0.8), the presence of hypertension (p=0.4), dyslipidemia (p=0.09) obesity (p=1), smoking status (p=0.2), presence of diabetes (p=0.2), a clinical history of acute myocardial infarction (p=0.7) or stroke (p=0.17). Compared to survivors, the non-survivor group exhibited a significantly higher incidence of cardiogenic shock (50% vs 24%, p=0.02), renal failure (64.3% vs 30.0%, p=0.004) and anaemia (35.7% vs 12.0%, p=0.02). Three-vessel disease was significantly higher in the non-survivor group (42.8% vs. 20.0%, p=0.03), while there was a significantly higher percentage of TIMI 3 flow postPCI in the infarct-related artery in the survivor group (80.% vs. 57.1%, p=0.03). The time from the onset of symptoms to revascularization was significantly higher in patients who died compared to those who survived (387.5 +/-211.3 minutes vs 300.8 +/-166.1 minutes, p=0.04), as was the time from the onset of cardiac arrest to revascularization (103.0 +/-56.34 minutes vs 67.0 +/-44.4 minutes, p=0.002). Multivariate analysis identified the presence of cardiogenic shock (odds ratio [OR]: 3.17, p=0.02), multivessel disease (OR: 3.0, p=0.03), renal failure (OR: 4.2, p=0.004), anaemia (OR: 4.07, p=0.02), need for mechanical ventilation >48 hours (OR: 8.07, p=0.0002) and a duration of stay in the ICU longer than 5 days (OR: 9.96, p=0.0002) as the most significant independent predictors for mortality in patients with OHCA and STEMI. Conclusion: In patients surviving an OHCA in the early phase of a myocardial infarction, the presence of cardiogenic shock, renal failure, anaemia or multivessel disease, as well as a longer time from the onset of symptoms or of cardiac arrest to revascularization, are independent predictors of mortality. However, the most powerful predictor of death is the duration of stay in the ICU and the requirement of mechanical ventilation for more than forty-eight hours.

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Predictors of Outcomes in Myocardial Infarction and Cardiogenic Shock

Acharya

2018

Cardiology in Review

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Predictors of mortality in patients with cardiogenic shock treated with primary percutaneous coronary intervention and intra-aortic balloon counterpulsation

Cited by 15 publications

References 26 publications

Timing of initiation of intra‐aortic balloon pump in patients with acute myocardial infarction complicated by cardiogenic shock: A meta‐analysis

Timing of initiation of intra‐aortic balloon pump in patients with acute myocardial infarction complicated by cardiogenic shock: A meta‐analysis

Predictors Of Mortality In Patients With ST-Segment Elevation Acute Myocardial Infarction And Resuscitated Out-Of-Hospital Cardiac Arrest

Predictors of Outcomes in Myocardial Infarction and Cardiogenic Shock

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