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Percutaneous coronary intervention in cardiogenic shock complicating acute ST-elevation myocardial infarction-a single centre experience Subban V; Gnanaraj A; Gomathi B; Janakiraman E; Pandurangi U; Kalidoss L; Ajit SMIndian Heart J 2012[Mar]; 64 (2): 152-8BACKGROUND: Mortality in acute myocardial infarction (AMI) complicated by cardiogenic shock (CS) approaches 70 - 80%, regardless of the type of pharmacological treatment. Early revascularisation improves survival in AMI with CS. Our aim is to assess the predictors of mid-term outcome after percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI) and CS. METHODS: Forty-one patients who underwent primary or rescue PCI for CS were analysed comparing their baseline, angiographic, PCI data, 30-day and 1-year survival. RESULTS: There were no significant differences between survivors and non-survivors in baseline characters, except for more number of transfer admissions (P= 0.0005), and cardiopulmonary resuscitations (P= 0.015) in the later group. The mean time between myocardial infarction (MI) onset to shock and MI onset to revascularisation were 12.8 +/- 12.9 hours and 17.0 +/- 16.8 hours, respectively. Patients with better pre-procedure thrombolysis in myocardial infarction (TIMI) flow in the infarct-related artery (IRA) had better survival (P= 0.0005). Successful PCI was achieved in 48.8% of patients. The 30-day mortality was 56.1% and all were prior to hospital discharge. Patients with successful PCI had better short-term survival in comparison with patients with failed PCI (80% vs 9.6%). Eighteen patients who survived at 30 days were followed up for 12-72 months (mean 28.5 +/- 5.4 months). Fifteen patients survived at 1 year after PCI and all were in good functional status. CONCLUSION: Mortality remains high even with PCI. Achieving IRA patency with TIMI 3 flow is the main determinant of survival. Survival and functional status are good in patients who are discharged from hospital.|*Angioplasty, Balloon, Coronary[MESH]|Aged[MESH]|Female[MESH]|Humans[MESH]|Male[MESH]|Middle Aged[MESH]|Shock, Cardiogenic/*mortality/*therapy[MESH]|Stents[MESH]|Survival Analysis[MESH]|Treatment Outcome[MESH]|Vascular Patency[MESH] |
