https://scholars.lib.ntu.edu.tw/handle/123456789/551711
標題: | Predictors of in-hospital mortality in patients with successful primary coronary intervention for acute ST-elevation myocardial infarction presenting as cardiogenic shock | 作者: | Yang S.-C. YI-CHIH WANG HWANG, JUEY-JEN Hsu K.-L. FU-TIEN CHIANG Tseng C.-D. |
公開日期: | 2010 | 卷: | 26 | 期: | 2 | 起(迄)頁: | 81-88 | 來源出版物: | Acta Cardiologica Sinica | 摘要: | Background: Predictors of hospital mortality in patients with successful primary coronary angioplasty for ST-elevation myocardial infarction (STEMI) presenting as cardiogenic shock (CS) remained less specified. Methods: From 1996 to 2007, we evaluated 64 patients (56 men, 65 ± 14 years) with STEMI and CS receiving successful intervention defined as residual stenosis < 40% by balloon angioplasty or < 20% by stenting with a TIMI grade 2 or 3 flow in the infarct-related artery. Results: Among the 64 patients, 37 (58%) had anterior infarction, and 26 (41%) had inferior infarction. In-hospital death occurred to 21 (33%) patients with a mean hospital stay of 11 ± 18 days. Hospital mortality was associated with several pre- and peri-procedural parameters including initial higher white blood cell (16,629 ± 6492 vs. 13,093 ± 5387 1/μL) and serum creatinine (1.7 ± 0.6 vs. 1.2 ± 0.3 mg/dl) levels, anterior infarction (76 vs. 49%), less stenting (38 vs. 65%), and post-intervention TIMI grade 2 flow (57 vs. 14%) (all p < 0.05). After multivariate analysis, initial creatinine ≧ 1.4 mg/dl (odds ratio: 8.9; p = 0.011, 95% confidence interval: 1.7-47.7), and anterior infarction (odds ratio: 5.9; p = 0.038, 95% confidence interval: 1.1-31.3) were independent predictors of in-hospital death. Conclusion: Anterior infarction or early renal dysfunction remained critical to the one-third mortality of successful intervention for patients with STEMI and CS. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/551711 | ISSN: | 1011-6842 | SDG/關鍵字: | acetylsalicylic acid; angiotensin receptor antagonist; beta adrenergic receptor blocking agent; clopidogrel; creatinine; dipeptidyl carboxypeptidase inhibitor; heparin; ticlopidine; acute heart infarction; aged; aorta balloon; article; cardiogenic shock; cause of death; continuous infusion; coronary artery blood flow; coronary stent; creatinine blood level; extracorporeal oxygenation; female; hospitalization; human; kidney dysfunction; kidney function; leukocyte count; loading drug dose; major clinical study; male; mortality; outcome assessment; percutaneous transluminal angioplasty; predictor variable; ST segment elevation myocardial infarction; transluminal coronary angioplasty |
顯示於: | 醫學院附設醫院 (臺大醫院) |
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