Predictors of Mortality in Acute Myocardial Infarction Complicated by Cardiogenic Shock despite Intra-Aortic Balloon Pump: Opportunities for Advanced Mechanical Circulatory Support in Asia
Abstract
:1. Introduction
2. Methods
2.1. Study Design and Population
2.2. Study Outcomes
2.3. Statistics
3. Results
4. Discussion
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations List
AMI | acute myocardial infarction |
CABG | coronary artery bypass graft |
CS | cardiogenic shock |
cVAD | catheter-based ventricular assist device |
ECMO | extracorporeal membrane oxygenation |
IABP | intra-aortic balloon pump |
MCS | mechanical circulatory support |
OOHCA | out-of-hospital cardiac arrest |
PCI | percutaneous coronary intervention |
SCAI | Society for Cardiovascular Angiography and Intervention |
STEMI | ST-elevation myocardial infarction |
References
- Thiele, H.; Ohman, E.M.; Desch, S.; Eitel, I.; de Waha, S. Management of cardiogenic shock. Eur. Heart J. 2015, 36, 1223–1230. [Google Scholar] [CrossRef] [PubMed]
- Hochman, J.S.; Sleeper, L.A.; Webb, J.G.; Sanborn, T.A.; White, H.D.; Talley, J.D.; Christopher, E.B.; Jacobs, A.K.; Slater, J.N.; Col, J.; et al. Early Revascularization in Acute Myocardial Infarction Complicated by Cardiogenic Shock. N. Engl. J. Med. 1999, 341, 625–634. [Google Scholar] [CrossRef] [PubMed]
- Hochman, J.S.; Sleeper, L.A.; Webb, J.G.; Dzavik, V.; Buller, C.E.; Aylward, P.; Col, J.; White, H.D.; SHOCK Investigators. Early Revascularization and Long-term Survival in Cardiogenic Shock Complicating Acute Myocardial Infarction. JAMA 2006, 295, 2511–2515. [Google Scholar] [CrossRef]
- Thiele, H.; Akin, I.; Sandri, M.; Fuernau, G.; De Waha, S.; Meyer-Saraei, R.; Nordbeck, P.; Geisler, T.; Landmesser, U.; Skurk, C.; et al. PCI Strategies in Patients with Acute Myocardial Infarction and Cardiogenic Shock. N. Engl. J. Med. 2017, 377, 2419–2432. [Google Scholar] [CrossRef] [PubMed]
- Wayangankar, S.A.; Bangalore, S.; McCoy, L.A.; Jneid, H.; Latif, F.; Karrowni, W.; Charitakis, K.; Feldman, D.N.; Dakik, H.A.; Mauri, L.; et al. Temporal Trends and Outcomes of Patients Undergoing Percutaneous Coronary Interventions for Cardiogenic Shock in the Setting of Acute Myocardial Infarction. JACC Cardiovasc. Interv. 2016, 9, 341–351. [Google Scholar] [CrossRef] [PubMed]
- Francis, G.S.; Bartos, J.A.; Adatya, S. Inotropes. J. Am. Coll. Cardiol. 2014, 63, 2069–2078. [Google Scholar] [CrossRef] [PubMed]
- Rihal, C.S.; Naidu, S.S.; Givertz, M.M.; Szeto, W.Y.; Burke, J.A.; Kapur, N.K.; Kern, M.; Garratt, K.N.; Goldstein, J.A.; Dimas, V.; et al. 2015 SCAI/ACC/HFSA/STS Clinical Expert Consensus Statement on the Use of Percutaneous Mechanical Circulatory Support Devices in Cardiovascular Care: Endorsed by the American Heart Assocation, the Cardiological Society of India, and Sociedad Latino Americana de CardiologiaIntervencion; Affirmation of Value by the Canadian Association of Interventional Cardiology-Association Canadienne de Cardiologied’intervention. J. Am. Coll. Cardiol. 2015, 65, e7–e26. [Google Scholar] [CrossRef] [PubMed]
- Werdan, K.; Gielen, S.; Ebelt, H.; Hochman, J.S. Mechanical circulatory support in cardiogenic shock. Eur. Heart J. 2014, 35, 156–167. [Google Scholar] [CrossRef] [PubMed]
- Ibanez, B.; James, S.; Agewall, S.; Antunes, M.J.; Bucciarelli-Ducci, C.; Bueno, H.; Caforio, A.L.P.; Crea, F.; Goudevenos, J.A.; Halvorsen, S.; et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur. Heart J. 2018, 39, 119–177. [Google Scholar] [CrossRef]
- Impella® Ventricular Support Systems for Use during Cardiogenic Shock and High-Risk PCI: Instructions for Use and Clinical Reference Manual. Available online: http://www.abiomed.com/impella-device-instructions-for-use (accessed on 13 June 2020).
- Lin, W.; Cherian, R.; Kang, G.S.; Tan, H.C.; Low, A.F. Catheter-Based Left Ventricular Assist Device for the Management of Cardiogenic Shock Complicating Acute Myocardial Infarction: A First-in-Singapore Experience. Ann. Acad. Med. 2020, 49, 707–711. [Google Scholar] [CrossRef]
- Basir, M.B.; Schreiber, T.; Dixon, S.; Alaswad, K.; Patel, K.; Almany, S.; Khandelwal, A.; Hanson, I.; George, A.; Ashbrook, M.; et al. Feasibility of early mechanical circulatory support in acute myocardial infarction complicated by cardiogenic shock: The Detroit cardiogenic shock initiative. Catheter. Cardiovasc. Interv. 2018, 91, 454–461. [Google Scholar] [CrossRef] [PubMed]
- Ba, M.R.F.; Kapur, N.K.; Patel, K.; Salam, M.A.; Schreiber, T.; Kaki, A.; Hanson, I.; Almany, S.; Timmis, S.; Dixon, S.; et al. Improved Outcomes Associated with the use of Shock Protocols: Updates from the National Cardiogenic Shock Initiative. Catheter. Cardiovasc. Interv. 2019, 93, 1173–1183. [Google Scholar] [CrossRef] [PubMed]
- Amin, A.P.; Spertus, J.A.; Curtis, J.P.; Desai, N.; Masoudi, F.A.; Bach, R.G.; McNeely, C.; Al-Badarin, F.; House, J.A.; Kulkarni, H.; et al. The Evolving Landscape of Impella Use in the United States Among Patients Undergoing Percutaneous Coronary Intervention With Mechanical Circulatory Support. Circulation 2020, 141, 273–284. [Google Scholar] [CrossRef] [PubMed]
- Naidu, S.S.; Baran, D.A.; Jentzer, J.C.; Hollenberg, S.M.; van Diepen, S.; Basir, M.B.; Grines, C.L.; Diercks, D.B.; Hall, S.; Kapur, N.K.; et al. SCAI SHOCK Stage Classification Expert Consensus Update: A Review and Incorporation of Validation Studies: This statement was endorsed by the American College of Cardiology (ACC), American College of Emergency Physicians (ACEP), American Heart Association (AHA), European Society of Cardiology (ESC) Association for Acute Cardiovascular Care (ACVC), International Society for Heart and Lung Transplantation (ISHLT), Society of Critical Care Medicine (SCCM), and Society of Thoracic Surgeons (STS) in December 2021. J. Am. Coll. Cardiol. 2022, 79, 933–946. [Google Scholar] [CrossRef] [PubMed]
- Thygesen, K.; Alpert, J.S.; Jaffe, A.S.; Chaitman, B.R.; Bax, J.J.; Morrow, D.A.; White, H.D. Fourth Universal Definition of Myocardial Infarction (2018). Circulation 2018, 138, e618–e651, Erratum in Circulation 2018, 138, e652. [Google Scholar] [CrossRef] [PubMed]
- Minha, S.; Barbash, I.M.; Dvir, D.; Ben-Dor, I.; Loh, J.P.; Pendyala, L.K.; Satler, L.F.; Pichard, A.D.; Torguson, R.; Waksman, R. Correlates for mortality in patients presented with acute myocardial infarct complicated by cardiogenic shock. Cardiovasc. Revasc. Med. 2014, 15, 13–17. [Google Scholar] [CrossRef] [PubMed]
- Dankiewicz, J.; Cronberg, T.; Lilja, G.; Jakobsen, J.C.; Levin, H.; Ullén, S.; Rylander, C.; Wise, M.P.; Oddo, M.; Cariou, A.; et al. Hypothermia versus Normothermia after Out-of-Hospital Cardiac Arrest. N. Engl. J. Med. 2021, 384, 2283–2294. [Google Scholar] [CrossRef]
- Sabatine, M.S.; Morrow, D.A.; Giugliano, R.P.; Burton, P.B.J.; Murphy, S.A.; McCabe, C.H.; Gibson, C.M.; Braunwald, E. Association of hemoglobin levels with clinical outcomes in acute coronary syndromes. Circulation 2005, 111, 2042–2049. [Google Scholar] [CrossRef]
- Yang, J.J.; Yu, D.; Wen, W.; Shu, X.-O.; Saito, E.; Rahman, S.; Gupta, P.C.; He, J.; Tsugane, S.; Xiang, Y.-B.; et al. Tobacco Smoking and Mortality in Asia: A Pooled Meta-analysis. JAMA Netw. 2019, 2, e191474. [Google Scholar] [CrossRef]
- Schwarz, B.; Abdel-Wahab, M.; Robinson, D.R.; Richardt, G. Predictors of mortality in patients with cardiogenic shock treated with primary percutaneous coronary intervention and intra-aortic balloon counterpulsation. Med. Klin. Intensivmed. Notfmed. 2016, 111, 715–722. [Google Scholar] [CrossRef]
- Thiele, H.; Zeymer, U.; Neumann, F.-J.; Ferenc, M.; Olbrich, H.-G.; Hausleiter, J.; Richardt, G.; Hennersdorf, M.; Empen, K.; Fuernau, G.; et al. Intraaortic balloon support for myocardial infarction with cardiogenic shock. N. Engl. J. Med. 2012, 367, 1287–1296. [Google Scholar] [CrossRef] [PubMed]
- Unverzagt, S.; Buerke, M.; de Waha, A.; Haerting, J.; Pietzner, D.; Seyfarth, M.; Thiele, H.; Werdan, K.; Zeymer, U.; Prondzinsky, R. Intra-aortic balloon pump counterpulsation (IABP) for myocardial infarction complicated by cardiogenic shock. Cochrane Database Syst. Rev. 2015, 3, CD007398. [Google Scholar] [CrossRef]
- Amsterdam, E.A.; Wenger, N.K.; Brindis, R.G.; Casey, D.E., Jr.; Ganiats, T.G.; Holmes, D.R., Jr.; Jaffe, A.S.; Jneid, H.; Kelly, R.F.; Kontos, M.C.; et al. 2014 AHA/ACC Guideline for the Management of Patients with Non-ST-Elevation Acute Coronary Syndromes: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J. Am. Coll. Cardiol. 2014, 64, e139–e228. [Google Scholar] [CrossRef]
- Ho, C.-H.; Chen, Z.-C.; Chu, C.-C.; Wang, J.-J.; Chiang, C.-Y. Temporal Trends of In-Hospital Mortality in Patients Treated with Intra-Aortic Balloon Pumping: A Nationwide Population Study in Taiwan, 1998–2008. PLoS ONE 2015, 10, e0131575. [Google Scholar] [CrossRef]
- Kim, H.K.; Jeong, M.H.; Ahn, Y.; Sim, D.S.; Chae, S.C.; Kim, Y.J.; Hur, S.H.; Seong, I.W.; Hong, T.J.; Choi, D.H.; et al. Clinical outcomes of the intra-aortic balloon pump for resuscitated patients with acute myocardial infarction complicated by cardiac arrest. J. Cardiol. 2016, 67, 57–63. [Google Scholar] [CrossRef] [PubMed]
- Thiele, H.; Zeymer, U.; Akin, I.; Behnes, M.; Rassaf, T.; Mahabadi, A.A.; Lehmann, R.; Eitel, I.; Graf, T.; Seidler, T.; et al. Extracorporeal Life Support in Infarct-Related Cardiogenic Shock. N. Engl. J. Med. 2023, 389, 1286–1297. [Google Scholar] [CrossRef]
- Seyfarth, M.; Sibbing, D.; Bauer, I.; Fröhlich, G.; Bott-Flügel, L.; Byrne, R.; Dirschinger, J.; Kastrati, A.; Schömig, A. A randomized clinical trial to evaluate the safety and efficacy of a percutaneous left ventricular assist device versus intra-aortic balloon pumping for treatment of cardiogenic shock caused by myocardial infarction. J. Am. Coll. Cardiol. 2008, 52, 1584–1588. [Google Scholar] [CrossRef] [PubMed]
- Ouweneel, D.M.; Eriksen, E.; Sjauw, K.D.; van Dongen, I.M.; Hirsch, A.; Packer, E.J.; Vis, M.M.; Wykrzykowska, J.J.; Koch, K.T.; Baan, J.; et al. Percutaneous Mechanical Circulatory Support Versus Intra-Aortic Balloon Pump in Cardiogenic Shock After Acute Myocardial Infarction. J. Am. Coll. Cardiol. 2017, 69, 278–287. [Google Scholar] [CrossRef]
- Schrage, B.; Ibrahim, K.; Loehn, T.; Werner, N.; Sinning, J.-M.; Pappalardo, F.; Pieri, M.; Skurk, C.; Lauten, A.; Landmesser, U.; et al. Impella Support for Acute Myocardial Infarction Complicated by Cardiogenic Shock. Circulation 2019, 139, 1249–1258. [Google Scholar] [CrossRef]
- Møller, J.E.; Engstrøm, T.; Jensen, L.O.; Eiskjær, H.; Mangner, N.; Polzin, A.; Schulze, P.C.; Skurk, C.; Nordbeck, P.; Clemmensen, P.; et al. Microaxial Flow Pump or Standard Care in Infarct-Related Cardiogenic Shock. N. Engl. J. Med. 2024, 390, 1382–1393. [Google Scholar] [CrossRef]
All (n = 242) | ||
---|---|---|
Patient demographics | ||
Age (years) | 64.1 ± 12.4 | |
Gender—male (%) | 213 (88.0%) | |
Height (m) | 164.0 ± 8.0 | |
Weight (kg) | 68.0 ± 13.3 | |
BMI (kg/m2) | 24.7 ± 4.4 | |
Smoking Status (%) | ||
Non-Smoker | 147 (60.7%) | |
Ex-smoker | 26 (10.7%) | |
Current smoker | 69 (28.5%) | |
Hypertension (%) | 147 (60.7%) | |
Hyperlipidemia (%) | 147 (60.7%) | |
Diabetes mellitus (%) | 116 (47.9%) | |
End-stage renal disease on dialysis (%) | 16 (6.6%) | |
Chronic obstructive lung disease (%) | 8 (3.3%) | |
Obstructive sleep apnea (%) | 3 (1.2%) | |
Prior ischemic heart disease (%) | 77 (31.8%) | |
Prior PCI (%) | 30 (12.4%) | |
Prior CABG (%) | 12 (5.0%) | |
Admission characteristics | ||
STEMI (%) | ||
STEMI | 158 (65.3%) | |
Non-STEMI | 84 (34.7%) | |
Territory of ST elevation | ||
Anterior | 87 (55.1%) | |
Non-anterior | 71 (44.9%) | |
Cardiac arrest prior to IABP (%) | 110 (45.5%) | |
Out of hospital cardiac arrest (%) | 59 (53.6%) | |
In-hospital cardiac arrest (%) | 51 (46.4%) | |
Inotrope/vasopressor use prior to IABP (%) | 192 (80.3%) | |
Culprit coronary artery | ||
Left anterior descending (%) | 103 (42.6%) | |
Right coronary artery (%) | 46 (19.0%) | |
Circumflex (%) | 29 (12.0%) | |
Others (%) | 36 (14.9%) | |
No clear culprit lesion identified (%) | 28 (11.6%) | |
Systolic blood pressure before IABP (mmHg) | 101.0 ± 32.2 | |
Diastolic blood pressure before IABP (mmHg) | 61.3 ± 18.6 | |
Heart rate before IABP (bpm) | 95.4 ± 25.2 | |
PCI performed (%) | 179 (74.0%) | |
CABG performed (%) | 18 (7.4%) | |
Hemoglobin on admission (g/dL) | 13.4 ± 2.2 | |
Serum sodium (mmol/dL) | 137.2 ± 4.7 | |
Serum potassium (mmol/dL) | 4.1 ± 0.7 | |
Serum creatinine (mmol/dL) | 173.0 ± 165.5 | |
First lactate (mmol/dL) | 6.58 ± 5.12 | |
First pH on arterial blood gas | 7.20 ± 0.33 | |
Echocardiographic characteristics | ||
Left ventricular ejection fraction (%) | 35.8 ± 12.3 | |
Left ventricle end-diastolic dimension (mm) | 49.0 ± 8.0 | |
Left ventricle end-systolic dimension (mm) | 38.2 ± 9.1 | |
Septal wall thickness (mm) | 10.4 ± 2.6 | |
Posterior wall thickness (mm) | 9.8 ± 2.1 | |
Left ventricular mass index (g/m2) | 103.8 ± 31.4 | |
Right atrium area (cm2) | 12.4 ± 3.2 | |
Right ventricular basal dimension (mm) | 22.7 ± 13.9 | |
Right ventricular mid-ventricular dimension (mm) | 17.2 ± 1.1 | |
Right ventricular long axis dimension (mm) | 43.3 ± 27.0 | |
Mitral inflow E-wave deceleration time (ms) | 146.5 ± 45.3 | |
Septal E/E’ | 17.5 ± 8.5 | |
Outcomes | ||
Duration of IABP support (days) | 3.2 ± 2.3 | |
Complications necessitating IABP removal (%) | 8 (3.3%) | |
Bleeding requiring transfusion (%) | 4 (1.7%) | |
Limb ischemia (%) | 3 (1.2%) | |
IABP site infection (%) | 0 (0.0%) | |
Need for inotropes/vasopressors (%) | 212 (88.0%) | |
Need for mechanical ventilation (%) | 198 (79.8%) | |
Duration of mechanical ventilation (days) | 4.1 ± 5.1 | |
Need for renal dialysis (%) | 64 (26.5%) | |
Duration of ICU stay (days) | 7.3 ± 7.8 | |
Duration of hospitalization (days) | 12.9 ± 16.1 | |
Survival to 30-days (%) | 109 (45.0%) |
Survivors (n = 109) | Non-Survivors (n = 131) | p-Value | |
---|---|---|---|
Patient demographics | |||
Age (years) | 62.6 ± 12.4 | 65.2 ± 12.2 | 0.055 |
Gender—male (%) | 99 (90.8%) | 112 (85.5%) | 0.207 |
Height (m) | 164.7 ± 7.7 | 163.3 ± 8.4 | 0.207 |
Weight (kg) | 67.2 ± 12.7 | 66.3 ± 14.2 | 0.457 |
BMI (kg/m2) | 24.8 ± 4.5 | 24.7 ± 4.3 | 0.904 |
Smoking Status | 0.001 | ||
Non-smoker | 54 (49.5%) | 91 (69.5%) | |
Previous | 11 (10.1%) | 15 (11.5%) | |
Current | 44 (40.4%) | 25 (19.1%) | |
Hypertension (%) | 60 (55.6%) | 85 (64.9%) | 0.142 |
Hyperlipidemia (%) | 64 (58.7%) | 81 (61.8%) | 0.623 |
Diabetes mellitus (%) | 50 (45.9%) | 64 (48.9%) | 0.645 |
End-stage renal disease on dialysis (%) | 4 (3.7%) | 12 (9.2%) | 0.090 |
Chronic obstructive lung disease (%) | 4 (3.7%) | 4 (3.1%) | 0.791 |
Obstructive sleep apnea (%) | 1 (0.9%) | 2 (1.5%) | 0.672 |
Prior ischemic heart disease (%) | 35 (32.1%) | 41 (31.3%) | 0.893 |
Prior PCI (%) | 18 (16.5%) | 12 (9.2%) | 0.086 |
Prior CABG (%) | 3 (2.8%) | 9 (6.9%) | 0.145 |
Admission characteristics | |||
STEMI (%) | 70 (64.2%) | 86 (65.6%) | 0.488 |
Non-STEMI | 39 (35.8%) | 45 (34.4%) | |
Anterior territory ST elevation? (%) | 0.398 | ||
Anterior | 34 (31.2%) | 51 (38.9%) | |
Non-anterior | 36 (33.0%) | 35 (26.7%) | |
Cardiac arrest prior to IABP (%) | 29 (26.6%) | 80 (61.1%) | <0.001 |
Out of hospital cardiac arrest (%) | 16 (53.3%) | 42 (51.9%) | 0.890 |
In-hospital cardiac arrest (%) | 13 (11.9%) | 38 (29.0%) | 0.003 |
Inotrope/vasopressor use prior to IABP (%) | 79 (72.5%) | 112 (87.5%) | 0.004 |
Culprit coronary lesion | 0.488 | ||
No | 11 (10.1%) | 17 (13.0%) | |
Yes | 98 (89.9%) | 114 (87.0%) | |
Systolic blood pressure before IABP (mmHg) | 103.6 ± 33.7 | 98.3 ± 30.9 | 0.220 |
Diastolic blood pressure before IABP (mmHg) | 63.0 ± 18.5 | 59.5 ± 18.5 | 0.230 |
Heart rate before IABP (bpm) | 92.0 ± 23.5 | 98.1 ± 26.4 | 0.067 |
PCI performed (%) | 85 (78.0%) | 93 (71.0%) | 0.218 |
CABG performed (%) | 14 (12.8%) | 4 (3.1%) | 0.004 |
Hemoglobin on admission (g/dL) | 13.76 ± 2.25 | 13.12 ± 2.18 | 0.018 |
Serum sodium (mmol/ dL) | 137.18 ± 3.91 | 137.30 ± 5.37 | 0.709 |
Serum potassium (mmol/dL) | 4.01 ± 0.67 | 4.23 ± 0.79 | 0.048 |
Serum creatinine (mmol/dL) | 144.1 ± 153.1 | 200.8 ± 173.6 | <0.001 |
First lactate (mmol/dL) | 4.85 ± 4.30 | 8.01 ± 5.31 | <0.001 |
First pH on arterial blood gas | 7.30 ± 0.13 | 7.12 ± 0.413 | <0.001 |
Echocardiographic characteristics | |||
Left ventricular ejection fraction (%) | 38.1 ± 11.9 | 31.4 ± 12.3 | <0.001 |
Left ventricle end-diastolic dimension (mm) | 49.08 ± 7.41 | 48.80 ± 9.12 | 0.633 |
Left ventricle end-systolic dimension (mm) | 38.1 ± 8.5 | 38.5 ± 10.3 | 0.930 |
Septal wall thickness (mm) | 10.5 ± 2.6 | 10.1 ± 2.5 | 0.378 |
Posterior wall thickness (mm) | 9.9 ± 2.3 | 9.5 ± 1.8 | 0.105 |
Left ventricular mass index (g/m2) | 106.2 ± 31.7 | 98.8 ± 29.7 | 0.169 |
Right atrium area (cm2) | 12.6 ± 3.1 | 12.0 ± 3.4 | 0.080 |
Right ventricular basal dimension (mm) | 22.1 ± 14.0 | 23.7 ± 14.0 | 0.521 |
Right ventricular mid-ventricular dimension (mm) | 16.5 ± 10.7 | 18.6 ± 11.8 | 0.317 |
Right ventricular long axis dimension (mm) | 40.9 ± 26.2 | 47.1 ± 28.4 | 0.169 |
Deceleration time (ms) | 146.9 ± 45.3 | 145.7 ± 46.0 | 0.859 |
Septal E/E’ | 16.7 ± 7.6 | 19.0 ± 10.1 | 0.284 |
Outcomes | |||
Duration of IABP support (days) | 3.5 ± 2.3 | 2.9 ± 2.2 | 0.003 |
Complications necessitating IABP removal (%) | 3 (2.8%) | 5 (3.8%) | 0.647 |
Bleeding requiring transfusion (%) | 3 (2.8%) | 1 (0.8%) | 0.231 |
Limb ischemia (%) | 1 (0.9%) | 2 (1.5%) | 0.672 |
IABP site infection (%) | 0 (0.0%) | 0 (0.0%) | NA |
Need for inotropes/ vasopressors (%) | 86 (79.6%) | 125 (95.4%) | <0.001 |
Need for mechanical ventilation (%) | 68 (62.4%) | 124 (94.7%) | <0.001 |
Duration of mechanical ventilation (days) | 4.3 ± 5.7 | 4.0 ± 4.6 | 0.424 |
Need for renal dialysis (%) | 21 (19.3%) | 43 (32.8%) | 0.018 |
Duration of ICU stay (days) | 9.6 ± 9.0 | 5.3 ± 5.9 | <0.001 |
Duration of hospitalization (days) | 20.6 ± 19.7 | 6.3 ± 8.1 | <0.001 |
(a) | |||
---|---|---|---|
Predictor | Adjusted Odds Ratio | 95% C.I. | p-Value |
Cardiac arrest prior to IABP | 4.002 | 2.279–7.028 | <0.001 |
Inotrope/vasopressor use prior to IABP | 2.419 | 1.180–4.962 | 0.016 |
STEMI | 1.347 | 0.750–2.420 | 0.002 |
(b) | |||
Predictor | Adjusted Odds Ratio | 95% C.I. | p-value |
First pH on arterial blood gas | 0.024 | 0.002–0.314 | 0.004 |
First lactate (mmol/dL) | 2.419 | 1.004–1.192 | 0.040 |
Hemoglobin level on admission (g/dL) | 0.833 | 0.711–0.978 | 0.025 |
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Lin, W.; Yip, A.C.L.; Cherian, R.; Chan, S.P.; Evangelista, L.K.M.; Sari, N.Y.; Ling, H.S.; Lim, Y.C.; Wong, R.C.C.; Tung, B.W.L.; et al. Predictors of Mortality in Acute Myocardial Infarction Complicated by Cardiogenic Shock despite Intra-Aortic Balloon Pump: Opportunities for Advanced Mechanical Circulatory Support in Asia. Life 2024, 14, 577. https://doi.org/10.3390/life14050577
Lin W, Yip ACL, Cherian R, Chan SP, Evangelista LKM, Sari NY, Ling HS, Lim YC, Wong RCC, Tung BWL, et al. Predictors of Mortality in Acute Myocardial Infarction Complicated by Cardiogenic Shock despite Intra-Aortic Balloon Pump: Opportunities for Advanced Mechanical Circulatory Support in Asia. Life. 2024; 14(5):577. https://doi.org/10.3390/life14050577
Chicago/Turabian StyleLin, Weiqin, Alfred Chung Lum Yip, Robin Cherian, Siew Pang Chan, Lauren Kay Mance Evangelista, Novi Yanti Sari, Hwei Sung Ling, Yoke Ching Lim, Raymond Ching Chiew Wong, Benjamin Wei Liang Tung, and et al. 2024. "Predictors of Mortality in Acute Myocardial Infarction Complicated by Cardiogenic Shock despite Intra-Aortic Balloon Pump: Opportunities for Advanced Mechanical Circulatory Support in Asia" Life 14, no. 5: 577. https://doi.org/10.3390/life14050577