OUTCOMES IN PATIENTS WITH CARDIOGENIC SHOCK FOLLOWING PRIMARY PERCUTANEOUS CORONARY INTERVENTION

Abstract

Objective: To compare the outcome of percutaneous coronary intervention withor without cardiogenic shock in acute myocardial infarction.

Methodology: This cross sectional study was conducted from 1st january 2015to 31st december 2016. All consecutive STEMI patients transferred from HospitalKualalumpur to IJN via HISNET for Primary percutaneous intervention wereincluded. They were divided into cardiogenic shock (CS) and non-cardiogenicshock (Non-CS) groups. SPSS Version 24.0 was used for study analysis.

Results: A total of 277were included. Of the study population, 247(89%) were innon- cardiogenic shock while 30 (11%) were in cardiogenic shock. Most ofbaseline characteristics were similar. Diabetes was present in 16 (53.3%)patients in CS and 93 (38%)patients in Non CS group (0.038). Mean first medicalcontact (FMC) to transfer time was 32 minutes for Non CS and 45 minutes in CSgroup (p =0.023). Successful PPCI was performed in 98% group as compare to87% in CS group, (p=0.015). In-hospital mortality was 7(23%) in CS group and6 (2%) in non CS group (p <0.001). One year mortality was 17 (7%) for non CSas compare to (27%) in CS group (p<0.05). Post procedure haemoglobin,number of inotropes needed at admission, baseline GFR, baseline PH werestrong predictors of mortality in cardiogenic shock patients.

Conclusion: Despite of similarities in most of risk factors, mortality rate of acutemyocardial infarction with Cardiogenic Shock was higher than non-cardiogenicshock.