ABSTRACT
Objectives: Cardiogenic shock [CS] is still the leading cause of in-hospital mortality in patients presenting with acute myocardial infarction [AMI]. The aim of this study was to determine the in-hospital mortality and clinical outcome in AMI patients presenting with CS in a tertiary hospital in Oman
Methods: This retrospective observational study included patients admitted to the cardiology department between January 2013 and December 2014. A purposive sampling technique was used, and 63 AMI patients with CS admitted to [36.5%] or transferred from a regional hospital [63.5%] were selected for the study
Results: Of 63 patients, 73% [n = 46] were Omani and 27% [n = 17] were expatriates: 79% were male and 21% were female. The mean age of patients was 60 +/- 12 years. The highest incidence of CS [30%] was observed in the 51-60 year age group. Diabetes mellitus [43%] and hypertension [40%] were the predominant risk factors. Ninety-two percent of patients had ST-elevation MI, 58.7% patients were thrombolysed, and 8% had non-ST-elevation MI. Three-quarters [75%] of CS patients had severe left ventricular systolic dysfunction [defined as ejection fraction <30%]. Coronary angiogram showed single vessel disease in 17%, double vessel disease in 40%, and triple vessel disease in 32% and left main disease in 11%. The majority of the patients [93.6%] underwent percutaneous coronary intervention [PCI], among them 23 [36.5%] underwent primary PCI. In-hospital mortality was 52.4% in this study
Conclusions: CS in AMI patients presenting to a tertiary hospital in Oman have high in-hospital mortality despite the majority undergoing PCI. Even though the in-hospital mortality is comparable to other studies and registries, there is an urgent need to determine the causes and find any remedies to provide better care for such patients, specifically concentrating on the early transfer of patients from regional hospitals for early PCI
ABSTRACT
Five compounds were isolated from the n-hexane and chloroform soluble fractions of a methanol extract of the stem bark of Erythrina variegata. The structures of the isolated compounds were elucidated as alpinum isoflavone [1], epilupeol [2], 6-hydroxygenistein [3], 3beta 28-dihydroxyolean-12-ene [4] and stigmasterol [5] by extensive spectroscopic studies, including high field NMR analyses. Different partitionates of the methanol extract exhibited mild to moderate antimicrobial activity and varying degrees of cytotoxicity. Although, alpinum isoflavone [1] has previously been reported from E. variegata, this is the first report of isolation of compounds 2-4 and stigmasterol from this plant species