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심인성쇼크로 관상동맥 중재술 중 대동맥 내 풍선펌프 사용 시 임상 경과

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Author(s)
이재필남창욱박정호배종엽김인철조윤경박형섭윤혁준김형섭허승호김윤년김권배
Keimyung Author(s)
Nam, Chang WookKim, In CheolCho, Yun KyeongPark, Hyoung SeobYoon, Hyuck JunKim, Hyung SeopHur, Seung HoKim, Yoon NyunKim, 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.
Alternative Title
Outcome of Percutaneous Coronary Intervention with
Intra-Aortic Balloon Pump in Patients with Cardiogenic Shock
Keimyung Author(s)(Kor)
남창욱
김인철
조윤경
박형섭
윤혁준
김형섭
허승호
김윤년
김권배
Publisher
School of Medicine
Citation
이재필 et al. (2015). 심인성쇼크로 관상동맥 중재술 중 대동맥 내 풍선펌프 사용 시 임상 경과. 대한내과학회지, 89(2), 186–191. doi: 10.3904/kjm.2015.89.2.186
Type
Article
ISSN
1738-9364
DOI
10.3904/kjm.2015.89.2.186
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/33108
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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