Prognostic impact of angiographic findings, procedural success, and timing of percutaneous coronary intervention in cardiogenic shock

Urgent revascularization is the mainstay of treatment in acute coronary syndrome (ACS) related cardiogenic shock (CS). The aim was to investigate the association of angiographic results with 90-day mortality. Procedural complications of percutaneous coronary intervention (PCI) were also examined. Th...

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Autores: Sabell, Tuija|||0000-0003-2764-7253, Banaszewski, Marek, Lassus, Johan, Nieminen, Markku S., Tolppanen, Heli|||0000-0002-3364-8554, Jäntti, Toni|||0000-0001-8348-0844, Kataja, Anu, Hongisto, Mari|||0000-0002-9838-1248, Køber, Lars, Sionis, Alessandro|||0000-0003-0843-9512, Parissis, John, Tarvasmäki, Tuukka|||0000-0003-3406-243X, Harjola, Veli-Pekka, Jurkko, Raija
Formato: artículo
Fecha de publicación:2020
País:España
Recursos:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:227666
Acesso em linha:https://ddd.uab.cat/record/227666
https://dx.doi.org/urn:doi:10.1002/ehf2.12637
Access Level:acceso abierto
Palavra-chave:Cardiogenic shock
Acute coronary syndrome
Percutaneous coronary intervention
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spelling Prognostic impact of angiographic findings, procedural success, and timing of percutaneous coronary intervention in cardiogenic shockSabell, Tuija|||0000-0003-2764-7253Banaszewski, MarekLassus, JohanNieminen, Markku S.Tolppanen, Heli|||0000-0002-3364-8554Jäntti, Toni|||0000-0001-8348-0844Kataja, AnuHongisto, Mari|||0000-0002-9838-1248Køber, LarsSionis, Alessandro|||0000-0003-0843-9512Parissis, JohnTarvasmäki, Tuukka|||0000-0003-3406-243XHarjola, Veli-PekkaJurkko, RaijaCardiogenic shockAcute coronary syndromePercutaneous coronary interventionUrgent revascularization is the mainstay of treatment in acute coronary syndrome (ACS) related cardiogenic shock (CS). The aim was to investigate the association of angiographic results with 90-day mortality. Procedural complications of percutaneous coronary intervention (PCI) were also examined. This CardShock (NCT01374867) substudy included 158 patients with ACS aetiology and data on coronary angiography and complications during PCI procedure. Survival analysis was conducted with Kaplan-Meier curves and Cox regression analysis. Median age was 67 ± 11 years, and 77% were men. During 90-day follow-up, 66 (42%) patients died. Patients with one-vessel disease (n = 49) had lower mortality than patients with two-vessel (n = 59) or three-vessel (n = 50) disease (25% vs. 48% vs. 52%, P = 0.011). Successful revascularization [Thrombolysis in Myocardial Infarction (TIMI) Flow 3 post-PCI) was achieved more often in survivors than non-survivors (81% vs. 60%, P = 0.019). The median symptom-to-balloon time was 340 (196-660) minutes, with no difference between survivors and non-survivors. In multivariable mortality analysis, multivessel disease (HR 2.59, CI 1.29-5.18) and TIMI flow <3 post-PCI (HR 2.41, CI 1.4-4.15) were associated with 90-day mortality. Procedural PCI complications were recorded in 51 (35%) patients, arrhythmic complications being the most common (n = 32, 63%). The incidence of complications was similar between survivors and non-survivors (31% vs. 42%, P = 0.21). Multivessel disease is associated with worse survival in ACS-related CS. In patients undergoing PCI, arrhythmic complications were common, but not associated with excess mortality. Successful revascularization of the IRA had positive effect on outcome despite delay from symptom onset.Universitat Autònoma de Barcelona 22020-01-0120202020-01-01Articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://ddd.uab.cat/record/227666https://dx.doi.org/urn:doi:10.1002/ehf2.12637reponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaInglésengopen accesshttp://purl.org/coar/access_right/c_abf2Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.https://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:ddd.uab.cat:2276662026-06-06T12:50:31Z
dc.title.none.fl_str_mv Prognostic impact of angiographic findings, procedural success, and timing of percutaneous coronary intervention in cardiogenic shock
title Prognostic impact of angiographic findings, procedural success, and timing of percutaneous coronary intervention in cardiogenic shock
spellingShingle Prognostic impact of angiographic findings, procedural success, and timing of percutaneous coronary intervention in cardiogenic shock
Sabell, Tuija|||0000-0003-2764-7253
Cardiogenic shock
Acute coronary syndrome
Percutaneous coronary intervention
title_short Prognostic impact of angiographic findings, procedural success, and timing of percutaneous coronary intervention in cardiogenic shock
title_full Prognostic impact of angiographic findings, procedural success, and timing of percutaneous coronary intervention in cardiogenic shock
title_fullStr Prognostic impact of angiographic findings, procedural success, and timing of percutaneous coronary intervention in cardiogenic shock
title_full_unstemmed Prognostic impact of angiographic findings, procedural success, and timing of percutaneous coronary intervention in cardiogenic shock
title_sort Prognostic impact of angiographic findings, procedural success, and timing of percutaneous coronary intervention in cardiogenic shock
dc.creator.none.fl_str_mv Sabell, Tuija|||0000-0003-2764-7253
Banaszewski, Marek
Lassus, Johan
Nieminen, Markku S.
Tolppanen, Heli|||0000-0002-3364-8554
Jäntti, Toni|||0000-0001-8348-0844
Kataja, Anu
Hongisto, Mari|||0000-0002-9838-1248
Køber, Lars
Sionis, Alessandro|||0000-0003-0843-9512
Parissis, John
Tarvasmäki, Tuukka|||0000-0003-3406-243X
Harjola, Veli-Pekka
Jurkko, Raija
author Sabell, Tuija|||0000-0003-2764-7253
author_facet Sabell, Tuija|||0000-0003-2764-7253
Banaszewski, Marek
Lassus, Johan
Nieminen, Markku S.
Tolppanen, Heli|||0000-0002-3364-8554
Jäntti, Toni|||0000-0001-8348-0844
Kataja, Anu
Hongisto, Mari|||0000-0002-9838-1248
Køber, Lars
Sionis, Alessandro|||0000-0003-0843-9512
Parissis, John
Tarvasmäki, Tuukka|||0000-0003-3406-243X
Harjola, Veli-Pekka
Jurkko, Raija
author_role author
author2 Banaszewski, Marek
Lassus, Johan
Nieminen, Markku S.
Tolppanen, Heli|||0000-0002-3364-8554
Jäntti, Toni|||0000-0001-8348-0844
Kataja, Anu
Hongisto, Mari|||0000-0002-9838-1248
Køber, Lars
Sionis, Alessandro|||0000-0003-0843-9512
Parissis, John
Tarvasmäki, Tuukka|||0000-0003-3406-243X
Harjola, Veli-Pekka
Jurkko, Raija
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Universitat Autònoma de Barcelona
dc.subject.none.fl_str_mv Cardiogenic shock
Acute coronary syndrome
Percutaneous coronary intervention
topic Cardiogenic shock
Acute coronary syndrome
Percutaneous coronary intervention
description Urgent revascularization is the mainstay of treatment in acute coronary syndrome (ACS) related cardiogenic shock (CS). The aim was to investigate the association of angiographic results with 90-day mortality. Procedural complications of percutaneous coronary intervention (PCI) were also examined. This CardShock (NCT01374867) substudy included 158 patients with ACS aetiology and data on coronary angiography and complications during PCI procedure. Survival analysis was conducted with Kaplan-Meier curves and Cox regression analysis. Median age was 67 ± 11 years, and 77% were men. During 90-day follow-up, 66 (42%) patients died. Patients with one-vessel disease (n = 49) had lower mortality than patients with two-vessel (n = 59) or three-vessel (n = 50) disease (25% vs. 48% vs. 52%, P = 0.011). Successful revascularization [Thrombolysis in Myocardial Infarction (TIMI) Flow 3 post-PCI) was achieved more often in survivors than non-survivors (81% vs. 60%, P = 0.019). The median symptom-to-balloon time was 340 (196-660) minutes, with no difference between survivors and non-survivors. In multivariable mortality analysis, multivessel disease (HR 2.59, CI 1.29-5.18) and TIMI flow <3 post-PCI (HR 2.41, CI 1.4-4.15) were associated with 90-day mortality. Procedural PCI complications were recorded in 51 (35%) patients, arrhythmic complications being the most common (n = 32, 63%). The incidence of complications was similar between survivors and non-survivors (31% vs. 42%, P = 0.21). Multivessel disease is associated with worse survival in ACS-related CS. In patients undergoing PCI, arrhythmic complications were common, but not associated with excess mortality. Successful revascularization of the IRA had positive effect on outcome despite delay from symptom onset.
publishDate 2020
dc.date.none.fl_str_mv 2
2020-01-01
2020
2020-01-01
dc.type.none.fl_str_mv Article
http://purl.org/coar/resource_type/c_6501
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://ddd.uab.cat/record/227666
https://dx.doi.org/urn:doi:10.1002/ehf2.12637
url https://ddd.uab.cat/record/227666
https://dx.doi.org/urn:doi:10.1002/ehf2.12637
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by-nc-nd/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Dipòsit Digital de Documents de la UAB
instname:Universitat Autònoma de Barcelona
instname_str Universitat Autònoma de Barcelona
reponame_str Dipòsit Digital de Documents de la UAB
collection Dipòsit Digital de Documents de la UAB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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