Clinical characteristics of patients with acute ST-segment elevation myocardial infarction complicated by perioperative cardiogenic shock
Tian Jinfan
Lv Shuzheng
Liu Yue
Song Xiantao
Zhang Min
Xu Feng
Yuan Fei
Ge Changjiang
Dai Jing
Abstract：Objective To analyze the clinical characteristics of patients with acute ST-segment elevation myocardial infarction (STEMI) and perioperative cardiogenic shock (CGS) during emergency percutaneous coronary intervention (PCI).Methods STEMI patients (n=415, male 368 and female 47) were chosen from the Beijing Anzhen Hospital from Jan. 2012 to Dec. 2015. All patients were divided, according to onset of perioperative CGS, into observation group (n=69) and control group (n=346). And then they were all given coronary angiography (CAG) for clearing the lesions of coronary artery, and received PCI. The clinical data including age, sex, smoking history and disease history (hypertension, diabetes, myocardial infarction and cerebral infarction) were collected from all patients. The indexes of blood routine examinations, liver and kidney functions, cardiac troponin I (cTnI), creatine kinase (CK) and creatine kinase-M B isoenzyme (CK-MB) were detected in all patients before PCI. The biochemical indexes including fasting triglyceride (TG), total cholesterol (TC), high-density lipoprotein-cholesterol (HDL-C) and low-density lipoprotein-cholesterol (LDL-C) were recorded. The values of left ventricular end-diastolic inner diameter (LVEDD), left ventricular end-systolic diameter (LVESD) and left ventricular ejection fraction (LVEF) were detected by using two-dimensional ultrasound.Results The percentages of patients aged>65 and with Killip grade>3, and heart rate were higher, and blood pressure was lower in observation group than those in control group (allP<0.05). The levels of neutrophile percentage, cTnI, CK, CK-MB, creatinine (Cr) and alanine aminotransferase (ALT) were significantly higher, and levels of platelet count, TC, TG and LDL-C were lower in observation group than those in control group (allP<0.05). The comparisons in LVEDD, LVESD and LVEF had no statistical significance between 2 groups (allP>0.05). The percentages of patients with right coronary lesion or right ventricular infarction increased,and percentages of patients with left anterior descending branch lesion or anterior myocardial infarction decreased in observation group compared with control group (allP<0.05). The comparisons in the duration from CGS onset to PCI and stent implantation had no statistical significance between 2 groups (allP>0.05). The percentages of perioperative died patients, and patients with bradyarrhythmia and tachyarrhythmia, applications of temporary pacemaker, electrical cardiovension and intraaortic balloon pumping (IABP), and vasoactive drug administration increases significantly in observation group compared with control group (allP<0.05).Conclusion The incidence of heart failure and percentages of cases of right coronary lesions and right ventricular infarction are higher, levels of blood fat and blood pressure are lower, and incidence of perioperative complications and mortality are higher in STEMI patients complicated by perioperative CGS compared with those without perioperative CGS.
Keywords：Acute ST-segment elevation myocardial infarctionCardiogenic shockPercutaneous coronary interventionClinical characteristics
Publication Date：2017-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 792-795 )