1. CLINICAL OUTCOMES OF PATIENTS WITH CARDIOGENIC SHOCK COMPLICATING ACUTE MYOCARDIAL INFARCTION: THE GULF-CARDIOGENIC SHOCK REGISTRY.
- Author
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Daoulah A, Alshehri M, Panduranga P, Aloui HM, Yousif N, Arabi A, Almahmeed W, Qutub MA, Elmahrouk A, Arafat AA, Kanbr O, Fathey Hussien A, Abdulhadi Aldossari M, Al Mefarrej AH, Shahzad Chachar T, Amin H, Livingston GS, Mohamed Al Rawahi AS, Alswuaidi J, Hashmani S, Al Jarallah M, Ghani MA, Alzahrani B, Jameel Naser M, Qenawi W, Hassan T, Alenezi A, Hersi AS, Alharbi W, Al Obaikan S, Saad Almalki S, Mohammed Ballool SA, Noor HA, Khalid AlSuwaidi M, Antony H, Albasiouny Alkholy MAE, Alkhodari K, Khan H, Alshehri A, Ghonim AA, Abualnaja S, Abdirahman Kahin M, Rajan R, Almerri K, Al Nasser FOM, Alhaydhal A, Ashour MA, Elamin OA, Jamjoom A, Wedinly SM, Elmahrouk Y, Dahdouh Z, Ross EM, Al Maashani S, Abohasan A, Tawfik W, Balghith M, Elganady A, Abdulhabeeb IAM, Borini RM, Basardah A, Alqahtani AM, Aldossari A, Alsuayri AO, Khan M, and Lotfi A
- Subjects
- Humans, Middle Aged, Male, Female, Aged, Shock, Cardiogenic mortality, Shock, Cardiogenic etiology, Shock, Cardiogenic therapy, Registries, Myocardial Infarction complications, Myocardial Infarction mortality, Hospital Mortality
- Abstract
Abstract: 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., Competing Interests: The authors report no conflicts of interest., (Copyright © 2024 by the Shock Society.)
- Published
- 2024
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