Immediate in-hospital outcomes after percutaneous revascularization of acute myocardial infarction complicated by cardiogenic shock

Table 1 Distribution of demographics and clinical characteristics patients with cardiogenic shock stratified by immediate outcome after primary percutaneous coronary intervention

	Total	Immediate outcome		P value
		Mortality	Survived
Total (n)	305	167	138
Gender
Male	222 (72.8)	114 (68.3)	108 (78.3)	0.051
Female	83 (27.2)	53 (31.7)	30 (21.7)
Age (years)	58.1 ± 11.8	59.4 ± 12	56.5 ± 11.5	0.031
Body mass index (kg/m2)	25.7 ± 2.9	25.6 ± 2.9	25.9 ± 3	0.346
Underweight	2 (0.7)	2 (1.2)	0 (0.0)	0.470
Healthy	150 (49.2)	84 (50.3)	66 (47.8)
Overweight	131 (43)	71 (42.5)	60 (43.5)
Obese	22 (7.2)	10 (6)	12 (8.7)
Killip Class
III	119 (39)	53 (31.7)	66 (47.8)	0.004
IV	186 (61)	114 (68.3)	72 (52.2)
Known risk factors
Diabetes	148 (48.5)	91 (54.5)	57 (41.3)	0.022
Hypertension	181 (59.3)	95 (56.9)	86 (62.3)	0.336
Smoke	80 (26.2)	40 (24)	40 (29)	0.320
Family history	8 (2.6)	4 (2.4)	4 (2.9)	0.784
Dyslipidemia	7 (2.3)	4 (2.4)	3 (2.2)	0.898
Chest pain to ER (min)	240 (120-360)	210 (120-360)	240 (120-360)	0.718
ER to lab time (min)	55 (39-76)	55 (35-70.11)	55 (40-80)	0.337
Total ischemic time (min)	285 (190-415)	280 (180-413)	287 (200-440)	0.672
ST depression in AVR	56 (18.4)	33 (19.8)	23 (16.7)	0.487

ER: Emergency room; AVR: Augmented vector right.

Table 2 Distribution of angiographic and procedural characteristics patients with cardiogenic shock stratified by immediate outcome after primary percutaneous coronary intervention

	Total	Immediate outcome		P value
		Mortality	Survived
Total (n)	305	167	138
Number of involved vessels
Single vessel disease (SVD)	56 (18.4)	15 (9)	41 (29.7)	< 0.001
Two vessel disease (2VD)	80 (26.2)	43 (25.7)	37 (26.8)
Three vessel disease (3VD)	145 (47.5)	100 (59.9)	45 (32.6)
Left main (LM)	2 (0.7)	1 (0.6)	1 (0.7)
LM + SVD	2 (0.7)	0 (0)	2 (1.4)
LM + 2VD	7 (2.3)	2 (1.2)	5 (3.6)
LM + 3VD	13 (4.3)	6 (3.6)	7 (5.1)
Infarct related artery
Left anterior descending artery	191 (62.6)	106 (63.5)	85 (61.6)	0.917
Right coronary artery	78 (25.6)	42 (25.1)	36 (26.1)
Left circumflex	31 (10.2)	17 (10.2)	14 (10.1)
Left main	5 (1.6)	2 (1.2)	3 (2.2)
Only LHC done	17 (5.6)	12 (7.2)	5 (3.6)	0.177
Only POBA	32 (10.5)	19 (11.4)	13 (9.4)	0.579
Lesion length (cm)	20 (15-26)	20 (15-26)	20 (15-26)	0.948
Bifurcations lesion	73 (23.9)	50 (29.9)	23 (16.7)	0.007
Side branch	57 (18.7)	37 (22.2)	20 (14.5)	0.087
Pre-procedure TIMI flow
0	290 (95.1)	152 (91)	138 (100)	0.005
I	8 (2.6)	8 (4.8)	0 (0.0)
II	6 (2)	6 (3.6)	0 (0.0)
III	1 (0.3)	1 (0.6)	0 (0.0)
Post-procedure TIMI flow
0	14 (4.6)	9 (5.4)	5 (3.6)	0.124
I	9 (3)	7 (4.2)	2 (1.4)
II	39 (12.8)	26 (15.6)	13 (9.4)
III	243 (79.7)	125 (74.9)	118 (85.5)
Tissue Myocardial Perfusion
0	20 (6.6)	10 (6)	10 (7.2)	0.731
I	18 (5.9)	11 (6.6)	7 (5.1)
II	62 (20.3)	37 (22.2)	25 (18.1)
III	205 (67.2)	109 (65.3)	96 (69.6)
Thrombus grading
G0-No	8 (2.6)	2 (1.2)	6 (4.3)	0.003
G1-Possible	14 (4.6)	7 (4.2)	7 (5.1)
G2-Small	8 (2.6)	1 (0.6)	7 (5.1)
G3-Moderate	39 (12.8)	14 (8.4)	25 (18.1)
G4-Large	55 (18)	32 (19.2)	23 (16.7)
G5-Total	181 (59.3)	111 (66.5)	70 (50.7)
Intraluminal defect	263 (86.2)	150 (89.8)	113 (81.9)	0.045
Export catheter use	138 (45.2)	62 (37.1)	76 (55.1)	0.002
Needed temporary pacemaker	103 (33.8)	101 (60.5)	2 (1.4)	< 0.001
ER	8 (7.8)	8 (7.9)	0 (0.0)	0.806
Cath lab	85 (82.5)	83 (82.2)	2 (100)
CCU	10 (9.7)	10 (9.9)	0 (0)
Needed intubation	134 (43.9)	131 (78.4)	3 (2.2)	< 0.001
ER	30 (22.4)	30 (22.9)	0 (0)	0.397
Cath lab	60 (44.8)	59 (45)	1 (33.3)
CCU	44 (32.8)	42 (32.1)	2 (66.7)
Needed inotropic support	129 (42.3)	127 (76)	2 (1.4)	< 0.001
ER	74 (57.4)	74 (58.3)	0 (0.0)	0.065
Cath lab	35 (27.1)	33 (26)	2 (100)
CCU	20 (15.5)	20 (15.7)	0 (0.0)
Needed IABP	111 (36.4)	81 (48.5)	30 (21.7)	< 0.001
LV dysfunction	256 (83.9)	152 (91)	104 (75.4)	< 0.001
Ejection fraction (%)	30 (30-40)	30 (30-40)	35 (30-45)	0.014

LV: Left ventricular; LHC: Left heart cath; TIMI: Thrombolysis in Myocardial Infarction; POBA: Plain old balloon angioplasty; IABP: Intra-aortic balloon pump; ER: Emergency room; CCU: Coronary care unit.

Table 3 Clinical predictors of immediate mortality after primary percutaneous coronary intervention of patients with cardiogenic shock

	Univariate		Multivariable
	OR (95%CI)	P value	OR (95%CI)	P value
Female	1.7 (1.0-2.8)	0.052	1.8 (1.0-3.3)	0.059
Age (years)	1.0 (1.0-1.0)	0.032	1.0 (1.0-1.0)	0.257
Killip class IV	2.0 (1.2-3.1)	0.004	2.0 (1.2-3.4)	0.008
Diabetes mellitus	1.7 (1.1-2.7)	0.022	1.5 (0.9-2.5)	0.126
Hypertension	0.8 (0.5-1.3)	0.337	-	-
Smoker	0.8 (0.5-1.3)	0.320	-	-
Total ischemic time ≥ 4 h	1.0 (0.6-1.7)	0.870	-	-
Multivessel disease	4.4 (2.4-8.3)	< 0.001	3.5 (1.8-6.9)	< 0.001
Bifurcations lesion	2.1 (1.2-3.7)	0.008	1.7 (0.8-3.5)	0.169
Side branch	1.7 (0.9-3.1)	0.090	0.9 (0.4-2.1)	0.839
Thrombus grade ≥ 4	2.9 (1.6-5.0)	< 0.001	2.6 (1.4-4.9)	0.003
Intraluminal defect	2.0 (1.0-3.8)	0.048	1.2 (0.6-2.6)	0.655
Left ventricular dysfunction	3.3 (1.7-6.4)	< 0.001	2.2 (0.8-6.3)	0.146
Ejection fraction (%)	1.0 (0.9-1.0)	0.002	1.0 (1.0-1.0)	0.542

OR: Odds ratio; CI: Confidence interval.