Open AccessCardiogenic Shock Predicts Long‐term Mortality in Hospital Survivors of STEMI Treated With Primary Percutaneous Coronary Intervention
Author(s) -
Hemradj Veemal V.,
Ottervanger Jan Paul,
van 't Hof Arnoud W.,
Dambrink Jan Henk,
Gosselink Marcel,
Kedhi Elvin,
Suryapranata Harry
Publication year - 2016
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.22580
Subject(s) - medicine , cardiogenic shock , percutaneous coronary intervention , cardiology , shock (circulatory) , emergency medicine , term (time) , intervention (counseling) , intensive care medicine , myocardial infarction , physics , quantum mechanics , psychiatry
Background ST ‐segment elevation myocardial infarction ( STEMI ) complicated by cardiogenic shock ( CS ) has a poor prognosis. Recently published data suggested, however, that CS does not affect long‐term mortality in hospital survivors of STEMI . We investigated whether this could be confirmed in a larger cohort. Hypothesis STEMI complicated by CS leads to worse long‐term survival. Methods A prospective cohort study was performed in 7412 consecutive patients with STEMI treated by primary percutaneous coronary intervention (angioplasty). The predictive value of CS on long‐term mortality was assessed in hospital survivors. Multivariate analysis, adjusting for differences in baseline variables, was performed to assess the independent prognostic value of CS . Results Cardiogenic shock was observed in 387 patients (5.2%). The total in‐hospital mortality was 254 (3.4%), and mortality was significantly higher in patients with CS (20.0% vs 2.6%; P < 0.001). The 1‐year mortality in hospital survivors was 10.3% in patients with CS and 3.9% in patients without CS ( P < 0.001). After multivariate analysis, CS was still a significant predictor of long‐term mortality in hospital survivors (hazard ratio: 2.6, 95% confidence interval: 1.64‐4.01). Conclusions Cardiogenic shock remains a strong predictor of long‐term mortality in hospital survivors of STEMI treated by primary percutaneous coronary intervention.