Predicting mortality in acute coronary syndrome with cardiogenic shock treated with percutaneous coronary intervention and intra- aortic balloon pump
Keywords:
Acute coronary syndrome, Cardiogenic shock, Percutaneous coronary intervention, Intra-aortic balloon pumpAbstract
Acute coronary syndrome with cardiogenic shock was life-threatening condition and high mortality rate. The current treatment for reduce mortality was insertion of intra-aortic balloon pump (IABP), but the mortality rate had still high. Had this study was retrospective descriptive study objective to study the factors that predict in hospital mortality in acute coronary syndrome with cardiogenic shock treated with percutaneous coronary intervention (PCI) and intra-aortic balloon pump and including in-hospital outcome in Udonthani hospital. The case record forms were used to collect the data from PCI register and medical records in 126 acute coronary syndrome patients with cardiogenic shock treated with percutaneous coronary intervention and intra-aortic balloon pump from January 2017, 1st to June 2018, 30th. Statistical analysis used percentage mean, standard deviation, pearson chi-square, univariate and multivarieate logistic regression analysis to identify independent predictors of in-hospital mortality.
Results: 126 patients with acute coronary syndrome with cardiogenic shock treated with PCI and IABP were analyzed. The mean age was 65.3 (S.D. 11.01) years, 69.8% were male, 78.6% had ST elevation myocardial infarction, 23.0% received fibrinolytic therapy before PCI, 31.7% had performed cardiopulmonary resuscitation (CPR) before PCI, 58.7% developed an acute kidney injury. All causes in-hospital mortality was 50 cases (39.7%), mortality from cardiac cause was 43 cases (86.0%). By multivariate analysis, the only independent predictor of mortality with statistically significant was CPR in cardiac catherization laboratory. (adjusted odd ratio 4.14; 95%CI 1.23-13.87, p=0.02)
Conclusion: CPR in cardiac catherization laboratory was the predictor of mortality in acute coronary syndrome with cardiogenic shock treated with percutaneous coronary intervention and intra-aortic balloon pump. Developing of patient referral system without entering the Udonthani emergency room will allow patients to receive a faster reperfusion therapy.
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