CLINICAL OUTCOMES OF PATIENTS WITH CARDIOGENIC SHOCK COMPLICATING ACUTE MYOCARDIAL INFARCTION: THE GULF-CARDIOGENIC SHOCK REGISTRY.
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Daoulah Amin, Alshehri Mohammed, Panduranga Prashanth, Aloui Hatem M, Yousif Nooraldaem, Arabi Abdulrahman, Almahmeed Wael, Qutub Mohammed A, Elmahrouk Ahmed, Arafat Amr A, Kanbr Omar, Fathey Hussien Adnan, Abdulhadi Aldossari Mubarak, Al Mefarrej Abdulmohsen H, Shahzad Chachar Tarique, Amin Haitham, Livingston Gladsy Selva, Mohamed Al Rawahi Abeer Said, Alswuaidi Jassim, Hashmani Shahrukh, Al Jarallah Mohammed, Ghani Mohamed Ajaz, Alzahrani Badr, Jameel Naser Maryam, Qenawi Wael, Hassan Taher, Alenezi Abdullah, Hersi Ahmad S, Alharbi Waleed, Al Obaikan Sultan, Saad Almalki Salman, Mohammed Ballool Sulafa Almukhtar, Noor Husam A, Khalid AlSuwaidi Manar, Antony Harvey, Albasiouny Alkholy Marwa Abd Elghany, Alkhodari Khaled, Khan Hassan, Alshehri Ali, Ghonim Ahmed A, Abualnaja Seraj, Abdirahman Kahin Mokhtar, Rajan Rajesh, Almerri Khaled, Al Nasser Faisal Omar M, Alhaydhal Ahmed, Ashour Mohammed Awad, Elamin Omer A, Jamjoom Ahmed, Wedinly Sary Mahmoud, Elmahrouk Youssef, Dahdouh Ziad, Ross Ethan M, Al Maashani Said, Abohasan Abdulwali, Tawfik Wael, Balghith Mohammed, Elganady Abdelmaksoud, Abdulhabeeb Ibrahim A M, Borini Rasha Mohammed, Basardah Ayman, Alqahtani Abdulrahman M, Aldossari Alaa, Alsuayri Abdullah Omair, Khan Mushira, Lotfi Amir
Аннотация
Background: There is a paucity of data regarding acute myocardial infarction (MI) complicated by cardiogenic shock (AMI-CS) in the Gulf region. This study addressed this knowledge gap by examining patients experiencing AMI-CS in the Gulf region and analyzing hospital and short-term follow-up mortality. Methods: The Gulf-Cardiogenic Shock registry included 1,513 patients with AMI-CS diagnosed between January 2020 and December 2022. Results: The incidence of AMI-CS was 4.1% (1,513/37,379). The median age was 60 years. The most common presentation was ST-elevation MI (73.83%). In-hospital mortality was 45.5%. Majority of patients were in SCAI (Society for Cardiovascular Angiography and Interventions shock classification) stage D and E (68.94%). Factors associated with hospital mortality were previous coronary artery bypass graft (odds ratio [OR]: 2.49; 95% confidence interval [CI]: 1.321-4.693), cerebrovascular accident (OR: 1.621; 95% CI: 1.032-2.547), chronic kidney disease (OR: 1.572; 95% CI: 1.158-2.136), non-ST-elevation MI (OR: 1.744; 95% CI: 1.058-2.873), cardiac arrest (OR: 5.702; 95% CI: 3.640-8.933), SCAI stage D and E (OR: 19.146; 95% CI: 9.902-37.017), prolonged QRS (OR: 10.012; 95% CI: 1.006-1.019), right ventricular dysfunction (OR: 1.679; 95% CI: 1.267-2.226), and ventricular septal rupture (OR: 6.008; 95% CI: 2.256-15.998). Forty percent had invasive hemodynamic monitoring, 90.02% underwent revascularization, and 45.80% received mechanical circulatory support (41.31% had intra-aortic balloon pump and 14.21% had extracorporeal membrane oxygenation/Impella devices). Survival at 12 months was 51.49% (95% CI: 46.44%-56.29%). Conclusions: The study highlighted the significant burden of AMI-CS in this region, with high in-hospital mortality. The study identified several key risk factors associated with increased hospital mortality. Despite the utilization of invasive hemodynamic monitoring, revascularization, and mechanical circulatory support in a substantial proportion of patients, the 12-month survival rate remained relatively low.