Predictors of outcome after percutaneous treatment for cardiogenic shock

Andrew G.C. Sutton, Paul Finn, J. A. Hall, A. A. Harcombe, R. A. Wright, M. A. De Belder

Research output: Contribution to journalArticlepeer-review

32 Citations (Scopus)

Abstract

Objectives: To determine predictors of outcome after percutaneous coronary intervention (PCI) in patients with cardiogenic shock complicating acute myocardial infarction. Methods: Retrospective analysis of a cohort of 113 patients undergoing emergency coronary angiography and attempted PCI for cardiogenic shock complicating acute myocardial infarction in a regional cardiothoracic unit. Results: In-hospital mortality was 51% (58 patients). Adverse outcome was associated with previous myocardial infarction, age over 70 years, cardiogenic shock complicating failure to respond to thrombolytic treatment (failed thrombolysis), and multivessel coronary artery disease. Multivariate logistic regression analysis showed that the first three factors were independent predictors of in-hospital death with odds ratios of 5.21 (95% confidence interval (CI) 1.85 to 14.69), 4.02 (95% CI 1.14 to 14.12), and 3.78 (95% CI 1.43 to 9.96), respectively. Conclusion: About 50% of patients with cardiogenic shock undergoing a strategy of urgent coronary angiography and PCI survive to hospital discharge. Survivors do well in the subsequent six months. Emergency PCI for cardiogenic shock reduces mortality from an expected 80% to about 50%. Clinical features can help determine which patients are most likely to gain from urgent coronary angiography and attempted PCI. Alternative strategies are needed to improve the outcome of patients who fare badly.

Original languageEnglish
Pages (from-to)339-344
Number of pages6
JournalHeart
Volume91
Issue number3
DOIs
Publication statusPublished - 1 Mar 2005

Fingerprint Dive into the research topics of 'Predictors of outcome after percutaneous treatment for cardiogenic shock'. Together they form a unique fingerprint.

Cite this