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Outcomes According to Presentation With Versus Without Cardiogenic Shock in Patients With Left Main Coronary Artery Stenosis and Acute Myocardial Infarction

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Author(s)
허승호
Alternative Author(s)
Hur, Seung Ho
Publication Year
2012
Abstract
This study is aimed at evaluating 1-year clinical outcomes and their predictors in patients
with unprotected left main coronary artery (ULMCA)-related acute myocardial infarction
(AMI). In total 248 patients diagnosed with AMI involving the ULMCA as the culprit
vessel and registered in the Korean Acute Myocardial Infarction database were enrolled in
this study. Patients were divided according to the absence (shock , n 206) or presence
(shock , n 42) of cardiogenic shock at initial presentation. Independent risk factors of
in-hospital cardiac death associated with ULMCA-related AMI were elucidated by multivariate
regression analysis. In-hospital mortality rates were 8.7% in the shock group and
47.6% in the shock group (p 0.001). During 1-year follow-up after discharge, major
adverse cardiac events developed in 16.3% of patients in the shock group and 18.2% of
patients in the shock group (p 0.828); cardiac death, MI, and ischemia-driven target
vessel revascularization were similar between the 2 groups at 1 year. On multivariate
analysis, initial shock presentation (odds ratio 8.9, confidence interval 4.1 to 19.2, p
0.004) and left ventricular ejection fraction <30% (odds ratio 7.6, confidence interval 2.7 to
21.1, p 0.001) were independent risk factors of in-hospital cardiac death associated with
ULMCA-related AMI. In conclusion, almost 1/2 of patients with ULMCA-related AMI
presenting with cardiogenic shock had a fatal in-hospital outcome compared to <10% of
those without cardiogenic shock; however, clinical outcomes after survival of the inhospital
period were not different between these groups. © 2012 Elsevier Inc. All rights
reserved. (Am J Cardiol 2012;110:36 –39)
Department
Dept. of Internal Medicine (내과학)
Publisher
School of Medicine
Citation
American Journal of Cardiology, Vol.110(1) : 36-39, 2012
Type
Article
ISSN
0002-9149
DOI
10.1016/j.amjcard.2012.02.044
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/34894
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