Chonnam Med J.  2009 Aug;45(2):92-97. 10.4068/cmj.2009.45.2.92.

Predictors of Mortality in Acute Myocardial Infarction Patients with Cardiogenic Shock Who Underwent Percutaneous Coronary Intervention with the Aid of an Intra-Aortic Balloon Pump

• Kim JH
• Jeong MH
• Choi JS
• Rhee JA
• Kim IS
• Choi OJ
• Kim EJ
• Sim DS
• Hong YJ
• Kim JH
• Ahn YK
• Cho JG
• Park JC
• Kang JC

• KMID: 2172267
• DOI: http://doi.org/10.4068/cmj.2009.45.2.92

Abstract

Despite recent advances in the treatment of acute myocardial infarction (AMI), the mortality of AMI patients with cardiogenic shock remains high, especially in those who fail to receive adequate coronary revascularization. Even though it is reported that coronary revascularization with an intra-aortic balloon pump (IABP) support improves survival, such patients are still at high risk of early mortality. Therefore, the present study aimed to discover predictors of death in AMI patients with cardiogenic shock undergoing percutaneous coronary intervention (PCI) with the aid of an IABP. Of AMI patients presenting with cardiogenic shock between June 2005 and September 2007, 51 patients (67.4+/-9.9 years of age, 30 males) who underwent PCI with IABP support were grouped into in-hospital survivors and non-survivors and were compared for clinical, laboratory, echocardiographic, and coronary angiographic characteristics. The overall in-hospital mortality rate of the study patients was 52.9%. There were no statistically significant differences between the two groups in the indices of baseline clinical characteristics, laboratory findings, echocardiographic findings, and coronary angiographic findings. Non-survivors received more mechanical ventilation (25 vs. 15, p=0.009), the duration of stay in the coronary care unit was shorter in the non-survivors (3.6+/-2.9 vs. 9.0+/-6.7 days, p=0.001), and systolic blood pressure was lower in non-survivors (75.6+/-57.2 vs. 105.3+/-44.5 mmHg, p=0.045). Multivariate regression analysis for predictors of in-hospital mortality demonstrated that diabetes mellitus (OR: 6.51, 1.225~34.632 95% CI: p=0.028) was significantly associated with in-hospital death. In AMI patients with cardiogenic shock who underwent PCI with IABP support, diabetes mellitus was a significant predictor of mortality.

Keyword

Shock; Myocardial infarction; Intra-aortic balloon pump

MeSH Terms

Blood Pressure
Coronary Care Units
Diabetes Mellitus
Hospital Mortality
Humans
Myocardial Infarction
Percutaneous Coronary Intervention
Respiration, Artificial
Shock
Shock, Cardiogenic
Survivors

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