Risk factors for in-hospital mortality in patients with acute myocardial infarction complicated with cardiogenic shock after primary percutaneous coronary intervention / 中华急诊医学杂志

ABSTRACT

Objective To observe the risk factors of in-hospital mortality in patients with acute myocardial infarction complicated with cardiogenic shock after primary percutaneous coronary intervention (PCI).Methods Totally 111 cases of acute myocardial infarction complicated with cardiogenic shock received acute PCI from 2009 to 2015 in Beijing Anzhen Hospital were enrolled.The cases were divided into the in-hospital death group (31 cases) and the in-hospital survival group (80 cases).The general information,clinical indicators,range of myocardial infarction,coronary lesions and management,complications,drug treatment and equipment assistance of the two groups were compared,and logistic regression analysis was used to analyze the risk factors of in-hospital mortality.Results The proportions of age ≥ 75 years,hyperlipidemia,serum creatinine ＞ 110 μmol/L,LVEF ＜ 40％,anterior myocardial infarction,three-vessel lesions of coronary artery,post-PCI TIMI flow grade ＜3,acute liver injury and acute kidney injury in the in-hospital death group were significantly higher than those in the in-hospital survival group (P ＜ 0.05).The proportion of IABP used in the in-hospital death group was significantly higher than that in the in-hospital survival group (P ＜ 0.05).There were no significant differences in the distribution of culprit lesion and the treatment of stenoses in nonculprit arteries between the two groups (P ＞ 0.05).Multivariate logistic regression analysis showed that age ≥ 75 years,threevessel coronary lesions,post-PCI TIMI flow grade ＜3 and acute renal injury were independent risk factors for hospital mortality (P ＜ 0.05).Conclusions Age ≥ 75 years,three-vessel lesions of coronary artery,post-PCI TIMI flow grade ＜3 and acute kidney injury were independent risk factors of in-hospital death in patients with acute myocardial infarction complicated with cardiogenic shock after primary PCI.