1. Prognostic impact of angiographic findings, procedural success, and timing of percutaneous coronary intervention in cardiogenic shock
- Author
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Sabell, Tuija, Banaszewski, Marek, Lassus, Johan, Nieminen, Markku S., Tolppanen, Heli, Jäntti, Toni, Kataja, Anu, Hongisto, Mari, Køber, Lars, Sionis, Alessandro, Parissis, John, Tarvasmäki, Tuukka, Harjola, Veli-Pekka, Jurkko, Raija, Universitat Autònoma de Barcelona, HUS Heart and Lung Center, Department of Medicine, Helsinki University Hospital Area, University of Helsinki, Kardiologian yksikkö, Clinicum, HUS Emergency Medicine and Services, and Department of Diagnostics and Therapeutics
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Male ,medicine.medical_specialty ,Acute coronary syndrome ,OCCLUSION ,medicine.medical_treatment ,Short Communication ,Short Communications ,Shock, Cardiogenic ,030204 cardiovascular system & hematology ,Revascularization ,Coronary Angiography ,Percutaneous coronary intervention ,03 medical and health sciences ,0302 clinical medicine ,TERM MORTALITY ,Internal medicine ,Medicine ,Diseases of the circulatory (Cardiovascular) system ,Humans ,030212 general & internal medicine ,Myocardial infarction ,cardiovascular diseases ,PREDICTORS ,Cardiogenic shock ,ARTERY ,Aged ,business.industry ,ELEVATION MYOCARDIAL-INFARCTION ,PCI ,Thrombolysis ,Middle Aged ,medicine.disease ,Prognosis ,3. Good health ,3121 General medicine, internal medicine and other clinical medicine ,RC666-701 ,Conventional PCI ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,TIMI - Abstract
Altres ajuts: This study was supported by grants from the Finnish Foundation for Cardiovascular Research, and Aarne Koskelo Foundation, Helsinki, Finland. Roche Diagnostics provided kits for the analysis of NT-proBNP and TnT. The funding sources had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication. Tuija Sabell (néeJavanainen) received following personal research grants: Acute Coronary Syndromes and secondary prevention grant from the Finnish Cardiac Society, grant supported by Astra Zeneca and grants from Paavo Nurmi Foundation and Paavo Ilmari Ahvenaisen säätiö. Dr Lassus has served on an advisory board for Boehringer Ingelheim, Medix Biochemica, Novartis, Servier, and Vifor Pharma and received lecture fees from Bayer, Boehringer Ingelheim, Pfizer, Novartis, Orion Pharma, and Vifor Pharma. Dr Parissis has received honoraria from Novartis and Orion Pharma. Urgent revascularization is the mainstay of treatment in acute coronary syndrome (ACS) related cardiogenic shock (CS). The aim was to investigate the association of angiographic results with 90-day mortality. Procedural complications of percutaneous coronary intervention (PCI) were also examined. This CardShock (NCT01374867) substudy included 158 patients with ACS aetiology and data on coronary angiography and complications during PCI procedure. Survival analysis was conducted with Kaplan-Meier curves and Cox regression analysis. Median age was 67 ± 11 years, and 77% were men. During 90-day follow-up, 66 (42%) patients died. Patients with one-vessel disease (n = 49) had lower mortality than patients with two-vessel (n = 59) or three-vessel (n = 50) disease (25% vs. 48% vs. 52%, P = 0.011). Successful revascularization [Thrombolysis in Myocardial Infarction (TIMI) Flow 3 post-PCI) was achieved more often in survivors than non-survivors (81% vs. 60%, P = 0.019). The median symptom-to-balloon time was 340 (196-660) minutes, with no difference between survivors and non-survivors. In multivariable mortality analysis, multivessel disease (HR 2.59, CI 1.29-5.18) and TIMI flow
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- 2020