Percutaneous coronary intervention and coronary artery bypass grafting in myocardial infarction complicated by cardiogenic shock.

IF 3.7 3区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Kardiologia polska Pub Date : 2025-01-01 Epub Date: 2025-02-20 DOI:10.33963/v.phj.104782

Mariusz Gąsior, Mateusz Tajstra, Marek Deja, Robert Gil, Jerzy Pacholewicz, Stanisław Bartuś, Marek Jasiński, Marek Gierlotka, Romuald Cichoń, Adam Witkowski, Jan Rogowski, Dariusz Dudek, Zdzisław Tobota, Wojciech Wojakowski, Kazimierz Widenka, Krzysztof Milewski, Bohdan Maruszewski, Janina Stępińska, Grzegorz Hirnle, Jacek Legutko, Piotr Suwalski, Przemysław Trzeciak, Piotr Przybyłowski, Tomasz Hrapkowicz

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引用次数: 0

Abstract

Background: Cardiogenic shock (CS) remains the leading cause of poor prognosis in patients with acute myocardial infarction (AMI), sustaining a high mortality rate of 40 to 50% within 30 days.

Aims: In this unique analysis of two national all-comers, real-life registries including patients with AMI complicated by CS, for whom early revascularization was planned, we aimed to compare the effect of percutaneous coronary revascularization (PCI) and coronary artery bypass grafting (CABG) on 30-day and 1-year all-cause mortality.

Methods: The study included consecutive patients with AMI complicated by CS included in the Polish Registry of Acute Coronary Syndromes (PL-ACS) and the Polish National Registry of Cardiac Surgical Procedures (KROK), treated with PCI and CABG, respectively. A layered analysis and Kaplan-Meier curves were used in the propensity score matched (PSM) groups.

Results: Between 2006 and 2022, a total of 1970 patients with AMI complicated by CS, with known coronary anatomy were included in PL-ACS and KROK registries. 1376 (69.8%) had PCI and 594 (30.2%) had CABG. Following a 1:1 PSM, a total of 822 patients were finally included in the analysis. The mortality rates were 48.2% in the PCI group compared with 38.6% in the CABG group at 30 days (P <0.001) and 53.5% compared with 41.1%, respectively, at 1 year (P <0.001).

Conclusions: Among patients with AMI affected by CS, those qualified to be treated with CABG had a higher survival rate at 30 days and one year as compared to those treated with PCI.

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经皮冠状动脉介入治疗及冠状动脉旁路移植术治疗心肌梗死并发心源性休克。

背景：心源性休克（CS）仍然是急性心肌梗死（AMI）患者预后不良的主要原因，30天内的死亡率高达40%至50%。目的：在这项独特的分析中，我们分析了两个国家的急症患者，包括AMI合并CS的患者，他们计划进行早期血运重建术，我们旨在比较经皮冠状动脉血运重建术（PCI）和冠状动脉旁路移植术（CABG）对30天和1年全因死亡率的影响。方法：该研究纳入了波兰急性冠脉综合征登记处（PL-ACS）和波兰国家心脏外科手术登记处（KROK）中分别接受PCI和CABG治疗的AMI合并CS的连续患者。倾向评分匹配（PSM）组采用分层分析和Kaplan-Meier曲线。结果：2006年至2022年间，共有1970例已知冠状动脉解剖结构的AMI合并CS患者被纳入PL-ACS和KROK登记。1376例（69.8%）行PCI， 594例（30.2%）行CABG。按照1:1的PSM，最终共有822例患者被纳入分析。PCI组30天死亡率为48.2%，CABG组为38.6% (P结论：在CS影响的AMI患者中，符合CABG治疗条件的患者30天和1年生存率高于PCI治疗组。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Kardiologia polska 医学-心血管系统

CiteScore

3.00

自引率

24.20%

发文量

431

审稿时长

3-6 weeks

期刊介绍： Kardiologia Polska (Kardiol Pol, Polish Heart Journal) is the official peer-reviewed journal of the Polish Cardiac Society (PTK, Polskie Towarzystwo Kardiologiczne) published monthly since 1957. It aims to provide a platform for sharing knowledge in cardiology, from basic science to translational and clinical research on cardiovascular diseases.