Qian-Feng Xiao, Xin Wei, Si Wang, Ying Xu, Yan Yang, Fang-Yang Huang, Mao Chen
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Kaplan-Meier plots were constructed, and concordance (C)-indices of the Global Registry of Acute Coronary Event (GRACE) score, Intra-aortic Balloon Pump in Cardiogenic Shock (IABP-SHOCK) II score, and IABP-SHOCK II score with CA were calculated.</p><p><strong>Results: </strong>Among the enrolled patients, 39 experienced CA and received cardiopulmonary resuscitation at admission. The 30-day and 1-year mortality rates were 40.9% and 47.0%, respectively. Neither univariate nor multivariate Cox regression analyses identified CA as a significant risk factor for 30-day and 1-year mortality. In C-statistics, the GRACE score exhibited a moderate effect (C-indices were 0.69 and 0.67, respectively), while the IABP-SHOCK II score had a better predictive performance (C-indices were 0.79 and 0.76, respectively) for the 30-day and 1-year mortality. Furthermore, CA did not enhance the predictive value of the IABP-SHOCK II score for 30-day (<i>p</i> = 0.864) and 1-year mortality (<i>p</i> = 0.888).</p><p><strong>Conclusions: </strong>Cardiac arrest at admission did not influence the survival of patients with AMI-CS. 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引用次数: 0
摘要
背景:入院时心脏骤停(CA)对急性心肌梗死(AMI)并发心源性休克(CS)患者预后的影响仍存在争议:我们于2018年至2021年在华西医院开展了一项回顾性研究,共纳入247例AMI并发CS(AMI-CS)患者。根据入院情况将患者分为CA组和非CA组。以30天和1年死亡率为主要终点,进行了单变量和多变量Cox回归分析。绘制了 Kaplan-Meier 图,并计算了全球急性冠状动脉事件登记(GRACE)评分、心源性休克主动脉内球囊反搏泵(IABP-SHOCK)II 评分和 IABP-SHOCK II 评分与 CA 的一致性(C)指数:结果:在登记的患者中,39 人经历了 CA 并在入院时接受了心肺复苏。30天和1年的死亡率分别为40.9%和47.0%。单变量或多变量 Cox 回归分析均未发现 CA 是 30 天和 1 年死亡率的重要风险因素。在C统计中,GRACE评分对30天和1年死亡率的预测效果一般(C指数分别为0.69和0.67),而IABP-SHOCK II评分对30天和1年死亡率的预测效果更好(C指数分别为0.79和0.76)。此外,CA并未提高IABP-SHOCK II评分对30天(p = 0.864)和1年(p = 0.888)死亡率的预测价值:结论:入院时心脏骤停不会影响急性心肌梗死-CS患者的存活率。结论:入院时心脏骤停不会影响 AMI-CS 患者的存活率。无论是否存在心脏骤停,都应优先考虑对 AMI-CS 患者进行积极复苏。
The Association between Cardiac Arrest and Mortality in Patients with Acute Myocardial Infarction Complicated by Cardiogenic Shock.
Background: The impact of cardiac arrest (CA) at admission on the prognosis of patients with acute myocardial infarction (AMI) complicated by cardiogenic shock (CS) remains a subject of debate.
Methods: We conducted a retrospective study at West China Hospital from 2018 to 2021, enrolling 247 patients with AMI complicated by CS (AMI-CS). Patients were categorized into CA and non-CA groups based on their admission status. Univariate and multivariate Cox regression analyses were performed, with 30-day and 1-year mortality as the primary endpoints. Kaplan-Meier plots were constructed, and concordance (C)-indices of the Global Registry of Acute Coronary Event (GRACE) score, Intra-aortic Balloon Pump in Cardiogenic Shock (IABP-SHOCK) II score, and IABP-SHOCK II score with CA were calculated.
Results: Among the enrolled patients, 39 experienced CA and received cardiopulmonary resuscitation at admission. The 30-day and 1-year mortality rates were 40.9% and 47.0%, respectively. Neither univariate nor multivariate Cox regression analyses identified CA as a significant risk factor for 30-day and 1-year mortality. In C-statistics, the GRACE score exhibited a moderate effect (C-indices were 0.69 and 0.67, respectively), while the IABP-SHOCK II score had a better predictive performance (C-indices were 0.79 and 0.76, respectively) for the 30-day and 1-year mortality. Furthermore, CA did not enhance the predictive value of the IABP-SHOCK II score for 30-day (p = 0.864) and 1-year mortality (p = 0.888).
Conclusions: Cardiac arrest at admission did not influence the survival of patients with AMI-CS. Active resuscitation should be prioritized for patients with AMI-CS, regardless of the presence of cardiac arrest.
期刊介绍:
RCM is an international, peer-reviewed, open access journal. RCM publishes research articles, review papers and short communications on cardiovascular medicine as well as research on cardiovascular disease. We aim to provide a forum for publishing papers which explore the pathogenesis and promote the progression of cardiac and vascular diseases. We also seek to establish an interdisciplinary platform, focusing on translational issues, to facilitate the advancement of research, clinical treatment and diagnostic procedures. Heart surgery, cardiovascular imaging, risk factors and various clinical cardiac & vascular research will be considered.