Predictors of short term mortality in patients with acute ST-elevation myocardial infarction complicated by cardiogenic shock / 中华心血管病杂志
Chinese Journal of Cardiology
;
(12): 695-701, 2010.
Article
in Chinese
| WPRIM
| ID: wpr-244184
ABSTRACT
<p><b>OBJECTIVE</b>To explore the independent risk factors associated with short term mortality in patients with ST-segment elevation acute myocardial infarction (STEMI) complicated by cardiogenic shock (CS).</p><p><b>METHODS</b>We analyzed data from Chinese patients with ST-segment elevation myocardial infarction (STEMI) and cardiogenic shock enrolled in the CREATE trial. Predictors of 30-day mortality were identified by univariate and multivariate logistic regression analysis using baseline and procedural variables.</p><p><b>RESULTS</b>The overall 30-day mortality of STEMI complicated by CS among the 517 patients [(68.5 ± 10.3) years and 57.6% male] was 62.3%. Logistic regression analysis showed that the independent risk factors of death included age (OR = 1.46, 95%CI 1.18 - 1.81), anterior infarction (OR = 2.01, 95%CI 1.29 - 3.11), admission glucose level > 7.8 mmol/L (OR = 2.17, 95%CI 1.26 - 3.73), serum sodium concentration < 130 mmol/L (OR = 2.21, 95%CI 1.21 - 4.04), left ventricular ejection fraction (LVEF) < 40% or sever left ventricular dysfunction (LVD) (OR = 3.78, 95%CI 2.28 - 6.27), no emergency revascularization (OR = 3.53, 95%CI 1.20 - 10.41) and diuretics use (OR = 1.90, 95%CI 1.21 - 2.97). Analysis using baseline clinical variables showed that the first five risk factors mentioned above were also the baseline risk factors fro death. The receiver operating characteristic curve for predicting the death of the two models was 0.81 (95%CI 0.77 - 0.86) and 0.80 (95%CI 0.75 - 0.84), respectively.</p><p><b>CONCLUSION</b>The 30-day mortality of patients with STEMI complicated by CS was over 60%. Age, anterior infarction, admission glucose level >7.8 mmol/L, serum sodium concentration < 130 mmol/L, left ventricular ejection fraction (LVEF) < 40% and no emergency revascularization were independent risk factors associated with 30-day mortality.</p>
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Prognosis
/
Shock, Cardiogenic
/
Therapeutics
/
Logistic Models
/
China
/
Survival Rate
/
Risk Factors
/
Mortality
/
Treatment Outcome
/
Myocardial Infarction
Type of study:
Etiology study
/
Prognostic study
/
Risk factors
Limits:
Aged
/
Female
/
Humans
/
Male
Country/Region as subject:
Asia
Language:
Chinese
Journal:
Chinese Journal of Cardiology
Year:
2010
Type:
Article
Similar
MEDLINE
...
LILACS
LIS