TY - JOUR

T1 - Prognostic importance of culprit lesion location in cardiogenic shock due to myocardial infarction

AU - Josiassen, Jakob

AU - Helgestad, Ole K. L.

AU - Møller, Jacob E.

AU - Holmvang, Lene

AU - Jensen, Lisette O

AU - Udesen, Nanna L. J.

AU - Ravn, Hanne B.

AU - Hassager, Christian

PY - 2021

Y1 - 2021

N2 - Background:As existing results are diverging, and the patient population has changed significantly, this study sought to investigate the prognostic importance of the culprit lesion location in patients with cardiogenic shock due to myocardial infarction (AMICS), in a contemporary and unselected patient population.Methods:From the recruitment area of two tertiary heart centres in Denmark, covering 3.9 million citizens corresponding to two-thirds of the Danish population, all AMICS patients in the period of 2010-2017 were individually identified and validated through patient records.Results:A total of 1716 patients with AMICS were identified. Immediate revascularization was performed in 1482 patients (86%). Among these, a culprit lesion in the left main coronary artery (LM) was associated with the highest 30-day mortality rate (66%), p(logrank)Conclusions:Among AMICS patients undergoing revascularization, a LM culprit lesion was associated with the highest short-term mortality, whereas patients with a culprit lesion in the remaining coronary arteries had comparable and lower mortality rates. Multivessel disease patients had similar prognoses irrespective of percutaneous coronary intervention approach and whether partial or complete revascularization was achieved.

AB - Background:As existing results are diverging, and the patient population has changed significantly, this study sought to investigate the prognostic importance of the culprit lesion location in patients with cardiogenic shock due to myocardial infarction (AMICS), in a contemporary and unselected patient population.Methods:From the recruitment area of two tertiary heart centres in Denmark, covering 3.9 million citizens corresponding to two-thirds of the Danish population, all AMICS patients in the period of 2010-2017 were individually identified and validated through patient records.Results:A total of 1716 patients with AMICS were identified. Immediate revascularization was performed in 1482 patients (86%). Among these, a culprit lesion in the left main coronary artery (LM) was associated with the highest 30-day mortality rate (66%), p(logrank)Conclusions:Among AMICS patients undergoing revascularization, a LM culprit lesion was associated with the highest short-term mortality, whereas patients with a culprit lesion in the remaining coronary arteries had comparable and lower mortality rates. Multivessel disease patients had similar prognoses irrespective of percutaneous coronary intervention approach and whether partial or complete revascularization was achieved.

KW - Cardiogenic shock

KW - myocardial infarction

KW - left main

KW - multivessel disease

KW - revascularization

KW - acute heart failure

KW - PERCUTANEOUS CORONARY INTERVENTION

KW - ANGIOGRAPHIC FINDINGS

KW - CARDIAC-ARREST

KW - PRIMARY PCI

KW - MULTIVESSEL

KW - MORTALITY

KW - REGISTRY

KW - ASSOCIATION

KW - SURVIVAL

KW - DISEASE

U2 - 10.1177/2048872620911848

DO - 10.1177/2048872620911848

M3 - Journal article

VL - 10

SP - 25

EP - 32

JO - European Heart Journal: Acute Cardiovascular Care

JF - European Heart Journal: Acute Cardiovascular Care

SN - 2048-8726

IS - 1

ER -