redictors of Hospital Mortality for Patients With Acute Myocardial Infarction That was Treated With an Artificial Ventilator and/or an Intra-aortic Balloon Pump

ABSTRACT

BACKGROUND AND OBJECTIVES: The mortality rate of complicated acute myocardial infarction (AMI) patients who require an artificial ventilator and/or an intra-aortic balloon pump (IABP) at a coronary care unit (CCU) has been reported to be very high. The aims of this study were to evaluate the mortality rate and to investigate the predictors of hospital death for these critically ill patients. SUBJECTS AND METHODS: We retrospectively analyzed a total of 134 complicated AMI patients who were treated with an artificial ventilator and/or an IABP at the CCU of Chonnam National University Hospital between January 2004 and December 2005. We compared the clinical characteristics, the laboratory, echocardiographic and coronary angiographic findings and the Global Registry of Acute Coronary Event (GRACE) score between the survivors and non-survivors. RESULTS: The overall mortality rate was 56.0%. The following variables were more common in non-survivors smoking and a history of coronary artery bypass grafting, the incidence of cardiogenic shock and the use of an IABP and/or percutaneous coronary intervention (PCI). The non-survivors had higher levels of high sensitivity C-reactive protein (hs-CRP) and N-terminal pro-brain natriuretic peptide (NT-proBNP) and a higher GRACE score (p<0.05, respectively). The predictive factors for hospital mortality according to multiple logistic regression analysis were the use of an IABP (odds ratio 3.52, 95% CI 1.182-11.541), PCI (odds ratio 0.29, 95% CI 0.057-0.843) and a high GRACE score (odds ratio 1.03, 95% CI 1.015-1.041). CONCLUSION: The predictive factors for hospital death for patients with AMI and who were treated by an IABP and/or an artificial ventilator were the use of IABP and PCI and a high GRACE score.