Forskning
Udskriv Udskriv
Switch language
Region Hovedstaden - en del af Københavns Universitetshospital
Udgivet

Jeopardized myocardium and survival in patients presenting to the catheterization laboratory with ST-elevation myocardial infarction and shock

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Relevance of coronary evaginations in bioresorbable vascular scaffolds

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Takotsubo syndrome: State-of-the-art review by an expert panel - Part 2

    Publikation: Bidrag til tidsskriftReviewForskningpeer review

  1. Coronary risk of patients with valvular heart disease: prospective validation of CT-Valve Score

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Vascular function in adults with cyanotic congenital heart disease

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Fractional Flow Reserve Guided PCI in Patients With and Without Left Ventricular Hypertrophy: a DANAMI-3-PRIMULTI Sub-study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Vis graf over relationer

OBJECTIVE: We aimed to relate the amount of jeopardized myocardium to mortality in shocked patients presenting to the catheterization laboratory with ST-elevation myocardial infarction (STEMI) and cardiogenic shock.

BACKGROUND: In contrast with historical data and previous professional guidance, contemporary randomized data suggest that multi-vessel revascularization in such patients does not improve survival; mechanistic insight is incomplete.

METHODS: Clinical databases identified cases of STEMI and shock triaged for primary percutaneous coronary intervention (PPCI) in Eastern Denmark from June 2011 to December 2014 (n = 128). British Cardiovascular Intervention Society (BCIS)-1 jeopardy scores were calculated from angiography. The study endpoint was 30-day mortality.

RESULTS: Median lactate values were 6.0 [2.9-10.7] mmol/L. 30-day mortality was 53.9%. 68% of patients had multi-vessel coronary disease. Median pre-PCI BCIS-1 myocardial jeopardy scores were 8 [6-10]. After multiple logistic regression increasing age (p = 0.008; odds ratio [OR] 1.06), lactate values (p = 0.017; OR 1.02), mechanical ventilation (p = 0.011; OR 1.25) and a systolic blood pressure ≤ 90 mmHg at end-case (p = 0.005; OR 1.26) were predictive of 30-day mortality. Post-PPCI culprit vessel TIMI 3 flow was associated with reduced mortality (p < 0.001; OR 0.66). There was no association between pre-PCI jeopardy scores and the primary endpoint.

CONCLUSIONS: In patients with STEMI and shock, myocardial jeopardy scores do not relate to patient outcomes. Jeopardy scores may be applied to existing datasets in order to understand why multi-vessel revascularization does not lead to the anticipated clinical benefits in cardiogenic shock.

OriginalsprogEngelsk
TidsskriftCardiovascular revascularization medicine : including molecular interventions
Vol/bind21
Udgave nummer7
Sider (fra-til)843-848
Antal sider6
ISSN1878-0938
DOI
StatusUdgivet - jul. 2020

Bibliografisk note

Copyright © 2019 Elsevier Inc. All rights reserved.

ID: 59117657