کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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5998029 | 1578997 | 2015 | 6 صفحه PDF | دانلود رایگان |

ObjectivesTo compare outcome in patients with acute myocardial infarction (MI) and cardiogenic shock (CS) presenting with and without out-of-hospital cardiac arrest (OHCA).BackgroundDespite general improvement in outcome after acute MI, CS remains a leading cause of death in acute MI patients with a high 30-day mortality rate. OHCA on top of cardiogenic shock may further increase mortality in these patients resulting in premature withdrawal of supportive therapy, but this is not known.Methods and resultsIn a retrospective study from 2008 to 2013, 248 consecutive patients admitted alive to a tertiary centre with the diagnosis of CS and acute MI were enrolled, 118 (48%) presented with OHCA and 130 (52%) without (non-OHCA patients). Mean lactate level at admission was significantly higher in OHCA patients compared with non-OCHA patients (9 mmol/l (SD 6) vs. 6 mmol/l (SD 4) p < 0.0001). Co-morbidities were more prevalent in the non-OHCA group. By univariate analysis age (Hazard ratio (HR) = 1.02 [CI 1.00-1.03], p = 0.01) and lactate at admission (HR = 1.06 [CI 1.03-1.09], p < 0.001), but not OHCA (HR = 1.1 [CI 0.8-1.4], p = NS) was associated with mortality. In multivariate analysis, only age (HR = 1.02 [CI 1.01-1.04], p = 0.003) and lactate level at admission (HR = 1.06 [1.03-1.09], p < 0.001) were independent predictors of mortality. One-week mortality was 63% in the OHCA group and 56% in the non-OHCA group, p = NS.ConclusionOHCA is not an independent predictor of mortality in patients with acute MI complicated by cardiogenic shock. This should encourage active intensive treatment of CS patients regardless of OHCA.
Journal: Resuscitation - Volume 87, February 2015, Pages 57-62