Long-term results after acute percutaneous transluminal coronary angioplasty in acute myocardial infarction and cardiogenic shock

被引:11
作者
Ammann, P [1 ]
Straumann, E [1 ]
Naegeli, B [1 ]
Schuiki, E [1 ]
Frielingsdorf, J [1 ]
Gerber, A [1 ]
Bertel, O [1 ]
机构
[1] Triemli Hosp, Div Cardiol, Dept Internal Med, Zurich, Switzerland
关键词
cardiogenic shock; long-term follow-up; acute percutaneous transluminal angioplasty (PTCA); acute myocardial infarction; TIMI flow;
D O I
10.1016/S0167-5273(01)00618-0
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The aim of this study was to determine the long-term outcome in unselected, consecutive patients after acute percutaneous transluminal angioplasty (PTCA) for acute myocardial infarction (AMI) complicated by cardiogenic shock. This involved a follow-up study from a prospectively conducted patient registry in a tertiary referral center, A total of 59 patients (10 female/49 male; median age 62 years (32-91)) with percutaneous transluminal cardiac interventions in primary cardiogenic shock were identified between January 1995 and January 2000. Twenty-two patients (37%) had been resuscitated successfully before intervention. The in-hospital mortality of shock patients was 36% (n=21, median age 68 (47-84)). The median follow-up of survivors was 18.1 (7-57.3) months, during which three further patients died (8%; two because of sudden cardiac deaths, one because of acute reinfarction). Achievement of thrombolysis in myocardial infarction (TIMI) flow III after acute PTCA (84% in survivors vs. 38% in non-survivors; P<0.001) and the absence of the left main coronary artery (3% survivors vs. 29% non-survivors P=0.003) as culprit lesion in patients with cardiogenic shock was strongly associated with an improved survival rate. A second cardiac intervention was performed in seven patients (18%). Overall functional capacity of shock survivors was good. At final follow-up, 80% of the survivors were completely asymptomatic. One patient had angina pectoris NYHA H, five patients dyspnoea NYHA class II. Exercise stress-test was performed in 24 of the 38 surviving patients, median exercise capacity was 100% (range 55-113%) of the age adjusted predicted value. In unselected patients with cardiogenic shock due to AMI, treatment with acute PTCA resulted in an in-hospital mortality of 36%, low late mortality and good functional capacity in long-term survivors. TIMI flow grade III after acute PTCA in patients with acute myocardial infarction complicated by cardiogenic shock was strongly associated with an improved survival rate whereas the left main coronary artery as culprit lesion was associated with worse outcome. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.
引用
收藏
页码:127 / 131
页数:5
相关论文
共 19 条
  • [1] [Anonymous], 1988, LANCET, V2, P349
  • [2] [Anonymous], 1986, LANCET, V1, P397
  • [3] Systematic direct angioplasty and stent-supported direct angioplasty therapy for cardiogenic shock complicating acute myocardial infarction: In-hospital and long-term survival
    Antoniucci, D
    Valenti, R
    Santoro, GM
    Bolognese, L
    Trapani, M
    Moschi, G
    Fazzini, PF
    [J]. JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1998, 31 (02) : 294 - 300
  • [4] CURRENT CONCEPTS - CARDIOGENIC-SHOCK
    CALIFF, RM
    BENGTSON, JR
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 1994, 330 (24) : 1724 - 1730
  • [5] CARDIOGENIC-SHOCK AFTER ACUTE MYOCARDIAL-INFARCTION - INCIDENCE AND MORTALITY FROM A COMMUNITY-WIDE PERSPECTIVE, 1975 TO 1988
    GOLDBERG, RJ
    GORE, JM
    ALPERT, JS
    OSGANIAN, V
    DEGROOT, J
    BADE, J
    CHEN, Z
    FRID, D
    DALEN, JE
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 1991, 325 (16) : 1117 - 1122
  • [6] TIMI frame count immediately after primary coronary angioplasty as a predictor of functional recovery in patients with TIMI 3 reperfused acute myocardial infarction
    Hamada, S
    Nishiue, T
    Nakamura, S
    Sugiura, T
    Kamihata, H
    Miyoshi, H
    Imuro, Y
    Iwasaka, T
    [J]. JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2001, 38 (03) : 666 - 671
  • [7] PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY IN PATIENTS WITH CARDIOGENIC-SHOCK
    HIBBARD, MD
    HOLMES, DR
    BAILEY, KR
    REEDER, GS
    BRESNAHAN, JF
    GERSH, BJ
    [J]. JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1992, 19 (03) : 639 - 646
  • [8] Early revascularization in acute myocardial infarction complicated by cardiogenic shock
    Hochman, JS
    Sleeper, LA
    Webb, JG
    Sanborn, TA
    White, HD
    Talley, JD
    Buller, CE
    Jacobs, AK
    Slater, JN
    Col, J
    McKinlay, SM
    LeJemtel, TH
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 1999, 341 (09) : 625 - 634
  • [9] One-year survival following early revascularization for cardiogenic shock
    Hochman, JS
    Sleeper, LA
    White, HD
    Dzavik, V
    Wong, SC
    Menon, V
    Webb, JG
    Steingart, R
    Picard, MH
    Menegus, MA
    Boland, J
    Sanborn, T
    Buller, CE
    Modur, S
    Forman, R
    Desvigne-Nickens, P
    Jacobs, AK
    Slater, JN
    LeJemtel, TH
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2001, 285 (02): : 190 - 192
  • [10] CURRENT SPECTRUM OF CARDIOGENIC-SHOCK AND EFFECT OF EARLY REVASCULARIZATION ON MORTALITY - RESULTS OF AN INTERNATIONAL REGISTRY
    HOCHMAN, JS
    BOLAND, J
    SLEEPER, LA
    PORWAY, M
    BRINKER, J
    COL, J
    JACOBS, A
    SLATER, J
    MILLER, D
    WASSERMAN, H
    MENEGUS, MA
    TALLEY, JD
    MCKINLAY, S
    SANBORN, T
    LEJEMTEL, T
    KOPER, B
    WARWICK, D
    SCHULMAN, S
    COOMBS, V
    RENKIN, J
    LAUWERS, R
    CURRIER, JW
    MAZUR, ME
    PEPE, AJ
    LANG, GR
    ZOLA, BE
    MELLOW, E
    SILVASI, D
    ESCALA, E
    GREENBERG, MA
    MUELLER, HS
    BREITBART, S
    CHARNEY, R
    LEVINE, B
    YUSSMAN, Z
    ETKA, W
    FORMAN, R
    MONRAD, ES
    NANA, M
    STROM, J
    GALVAO, M
    WEINER, B
    GORE, J
    OKIKE, O
    BORBONE, M
    MOSES, JW
    CHARASH, B
    COHEN, N
    MOREYRA, AE
    PALMERI, S
    [J]. CIRCULATION, 1995, 91 (03) : 873 - 881