1. CLINICAL OUTCOMES OF PATIENTS WITH CARDIOGENIC SHOCK COMPLICATING ACUTE MYOCARDIAL INFARCTION: THE GULF-CARDIOGENIC SHOCK REGISTRY
- Author
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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, and Lotfi, Amir
- 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.
- Published
- 2024
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