Analysis of clinical prognosis in patients with cardiogenic shock after acute myocardial infarction in ICU

WU Hua-jing; ZHANG Ping; SUN Su-yang; DING Guo-ping

doi:10.3969/j.issn.1674-4055.2016.11.21

Abstract：Objective To explore the clinical prognosis and its influencing factors in patients with cardiogenic shock after acute myocardial infarction, and to provide reference basis to make the treatment strategy.Methods the clinical data of 110 patients with cardiogenic shock after acute myocardial infarction, who admitted in the cardiovascular ICU in January 2010-December 2015 in Jiangsu Province People's Hospital, were retrospectively analyzed. All cases were divided into Survival Group and Death Group according to the clinical prognosis. The influencing factors to the clinical prognosis in patients with cardiogenic shock after acute myocardial infarction were analyzed by single-factor analysis and multi-factors logistic regression analysis.Results ①There were 52 cases (47.28%) died in the ICU. ②The results of single-factor analysis showed that conditions of hypertension, diabetes mellitus, past coronary heart disease, systolic and diastolic blood pressure when admitting, atrial fibrillation, ventricular tachycardia/ventricular fibrillation, atrioventricular block of II/ III degree, pulmonary infection, chronic renal insufficiency, PCI, IABP and ECMO were significantly different between Survival Group and Death Group (P<0.05 or P<0.01). ③The results of multi-factors logistic regression analysis showed that conditions of hypertension, diabetes mellitus, past coronary heart disease atrioventricular block of II/ III degree and pulmonary infection were risk factors to cardiogenic shock after acute myocardial infarction, and PCI, IABP and ECMO were protective factors to cardiogenic shock after acute myocardial infarction (P<0.05 orP<0.01).Conclusion Conditions of hypertension, diabetes mellitus, past coronary heart disease atrioventricular block of II/ III degree and pulmonary infection are risk factors to cardiogenic shock after acute myocardial infarction, and PCI, IABP and ECMO can reduce the death rate in patients with cardiogenic shock after acute myocardial infarction in ICU.