Determinants of in-hospital death in left main coronary artery myocardial infarction complicated by cardiogenic shock

被引:22
|
作者
Sakakura, Kenichi [1 ]
Kubo, Norifumi [1 ]
Hashimoto, Shigemasa [2 ]
Ikeda, Nahoko [1 ]
Funayama, Hiroshi [1 ]
Hirahara, Taishi [1 ]
Sugawara, Yoshitaka [1 ]
Yasu, Takanori [1 ]
Ako, Junya [3 ]
Kawakami, Masanobu [1 ]
Momomura, Shin-ichi [1 ]
机构
[1] Jichi Med Univ, Saitama Med Ctr, Dept Integrated Med 1, Div Cardiovasc Med, Omiya, Saitama 3308503, Japan
[2] Saga Univ, Fac Med, Dept Cardiovasc & Renal Med, Saga 840, Japan
[3] Stanford Univ, Sch Med, Div Cardiovasc Med, Stanford, CA 94305 USA
关键词
left main; acute myocardial; infarction; shock; in-hospital death;
D O I
10.1016/j.jjcc.2008.03.008
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Acute myocardial infarction (AMI) due to left main coronary artery disease is associated with significantly elevated morbidity and mortality. The aim of this study was to identify the predictors of in-hospital death from left main AMI complicated by cardiogenic shock. Methods: Clinical record review identified a total of 25 cases of left main AMI with cardiogenic shock. Patients' background characteristics, Laboratory data, and angiographic findings were analyzed according to the in-hospital mortality. Results: In this patient subset, in-hospital mortality (60%) was associated with a history of hypertension (p = 0.02) and a higher heart rate (p = 0.02). Furthermore, in-hospital mortality was also associated with a complete right bundle branch block (CRBBB) pattern in the admission ECG (p = 0.01) and low HCO3- (p = 0.0004). In step-wise logistic regression analysis, a CRBBB pattern (OR 48.59, 95% CI 1.34-1768.10, p=0.03) and low HCO3- (OR 0.62, 95% CI 0.40-0.94, p=0.02) were found to be independent predictors of mortality.
引用
收藏
页码:24 / 29
页数:6
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