심인성쇼크로 관상동맥 중재술 중 대동맥 내 풍선펌프 사용 시 임상 경과
- Author(s)
- 이재필; 남창욱; 박정호; 배종엽; 김인철; 조윤경; 박형섭; 윤혁준; 김형섭; 허승호; 김윤년; 김권배
- Keimyung Author(s)
- Nam, Chang Wook; Kim, In Cheol; Cho, Yun Kyeong; Park, Hyoung Seob; Yoon, Hyuck Jun; Kim, Hyung Seop; Hur, Seung Ho; Kim, Yoon Nyun; Kim, Kwon Bae
- Department
- Dept. of Internal Medicine (내과학)
- Journal Title
- 대한내과학회지
- Issued Date
- 2015
- Volume
- 89
- Issue
- 2
- Keyword
- Acute coronary syndrome(급성관상동맥증후군); Shock, Cardiogenic(심인성 쇼크); Percutaneous coronary intervention(경피적 관상동맥 중재술); Intra-aortic balloon pumping(대동맥 내 풍선 펌프)
- Abstract
- Background/Aims: The mortality of hospitalized patients undergoing treatment with an intra-aortic balloon pump (IABP) due to
cardiogenic shock is well known as quite high. The aim of this study was to evaluate the outcome of percutaneous coronary intervention
(PCI) with an IABP in patients with acute coronary syndrome (ACS) and cardiogenic shock and identify the predictors of
in-hospital mortality.
Methods: 134 patients who underwent PCI with IABP due to ACS complicated by cardiogenic shock were consecutively enrolled.
Outcomes were obtained and analyzed during hospitalization and after 1 year.
Results: The incidence of all-cause mortality was 35.8% (in-hospital mortality, 34.3%; 1-year mortality, 1.5%). The nonsurvival
group exhibited higher peak levels of creatine kinase MB; lower ejection fractions; and higher incidences of ST elevation myocardial
infarction, ventricular arrhythmia, and use of an assistive device than did the survival group. Aging (hazard ratio 2.839;
95% confidence interval 1.408-5.723; p = 0.004), the use of a temporary pacemaker (2.035; 1.114-3.720; 0.021), the use of a mechanical
ventilator (4.376; 1.852-10.341; 0.001), and the performance of cardiopulmonary resuscitation (CPR) (2.219; 1.017-4.839;
0.045) were independent predictors for in-hospital mortality. However, out-of-hospital mortality among in-hospital survivors was
not affected by predictors of in-hospital mortality.
Conclusions: The incidence of in-hospital mortality was high, as expected in patients undergoing PCI with IABP due to ACS with
cardiogenic shock. Aging, CPR, and additional procedures such as pacemaker use and mechanical ventilation were predictors of
in-hospital mortality. However, the patients who were successfully discharged after the complex procedure showed acceptable
1-year outcomes.
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