CLINICAL OUTCOMES OF PATIENTS WITH CARDIOGENIC SHOCK COMPLICATING ACUTE MYOCARDIAL INFARCTION: THE GULF-CARDIOGENIC SHOCK REGISTRY

Background: There is a paucity of data regarding acute myocardial infarction (MI) complicated by cardiogenic shock (AMI-CS) in the Gulf region. This study addressed this knowledge gap by examining patients experiencing AMI-CS in the Gulf region and analyzing hospital and short-term follow-up mortality. Methods: The Gulf-Cardiogenic Shock registry included 1,513 patients with AMI-CS diagnosed between January 2020 and December 2022. Results: The incidence of AMI-CS was 4.1% (1,513/37,379). The median age was 60 years. The most common presentation was ST-elevation MI (73.83%). In-hospital mortality was 45.5%. Majority of patients were in SCAI (Society for Cardiovascular Angiography and Interventions shock classification) stage D and E (68.94%). Factors associated with hospital mortality were previous coronary artery bypass graft (odds ratio [OR]: 2.49; 95% confidence interval [CI]: 1.321-4.693), cerebrovascular accident (OR: 1.621; 95% CI: 1.032-2.547), chronic kidney disease (OR: 1.572; 95% CI: 1.158-2.136), non-ST-elevation MI (OR: 1.744; 95% CI: 1.058-2.873), cardiac arrest (OR: 5.702; 95% CI: 3.640-8.933), SCAI stage D and E (OR: 19.146; 95% CI: 9.902-37.017), prolonged QRS (OR: 10.012; 95% CI: 1.006-1.019), right ventricular dysfunction (OR: 1.679; 95% CI: 1.267-2.226), and ventricular septal rupture (OR: 6.008; 95% CI: 2.256-15.998). Forty percent had invasive hemodynamic monitoring, 90.02% underwent revascularization, and 45.80% received mechanical circulatory support (41.31% had intra-aortic balloon pump and 14.21% had extracorporeal membrane oxygenation/Impella devices). Survival at 12 months was 51.49% (95% CI: 46.44%-56.29%). Conclusions: The study highlighted the significant burden of AMI-CS in this region, with high in-hospital mortality. The study identified several key risk factors associated with increased hospital mortality. Despite the utilization of invasive hemodynamic monitoring, revascularization, and mechanical circulatory support in a substantial proportion of patients, the 12-month survival rate remained relatively low.

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Journal
Shock
Published
2024-08-12
DOI
https://doi.org/10.1097/shk.0000000000002433
Citations
13
Primary Topic
Cardiac Arrest and Resuscitation
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article
Field-Weighted Citation Impact
8.98
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article

CLINICAL OUTCOMES OF PATIENTS WITH CARDIOGENIC SHOCK COMPLICATING ACUTE MYOCARDIAL INFARCTION: THE GULF-CARDIOGENIC SHOCK REGISTRY

Rajesh Rajan, Ahmed Alhaydhal, Ahmed Abdullah Jamjoom, Shahrukh Hashmani et al.
13 citations
Shock
Cardiac Arrest and Resuscitation
8.98
article

CLINICAL OUTCOMES OF PATIENTS WITH CARDIOGENIC SHOCK COMPLICATING ACUTE MYOCARDIAL INFARCTION: THE GULF-CARDIOGENIC SHOCK REGISTRY

Rajesh Rajan, Ahmed Alhaydhal, Ahmed Abdullah Jamjoom, Shahrukh Hashmani, Mohamed Ajaz Ghani, Abdelmaksoud Elganady, Maryam Jameel Naser, Adnan Fathey Hussien, Youssef Elmahrouk, Prashanth Panduranga, Mohammed Al‐Jarallah, Amr A. Arafat, Amir Lotfi, Mohammed Alshehri, Amin Daoulah, Wael Tawfik, Hassan Khan, Said Al Maashani, Ziad Dahdouh, Ahmed A. Ghonim, Seraj Abualnaja, Ahmed F. Elmahrouk, Mohammed Awad Ashour, Wael Almahmeed, Tarique Shahzad Chachar, Ibrahim A. M. Abdulhabeeb, Faisal Omar M. Al Nasser, Khaled Alkhodari, Omer A. Elamin, Alaa Aldossari, Ahmad Hersi, Sulafa Ballool, Mohammed Balghith, Husam A. Noor, Badr Alzahrani, Wael Qenawi, Abdulrahman Arabi, Mubarak Aldossari, Khaled Almerri, Abdulwali Abohasan, Waleed Alharbi, Omar Kanbr, Haitham Amin, Abdulrahman Alqahtani, Ali Alshehri, Abdulmohsen H. Al Mefarrej, Abeer Said Mohamed Al Rawahi, Jassim Alswuaidi, Sultan Al Obaikan, Manar Khalid AlSuwaidi, Harvey Antony, Marwa Abd Elghany Albasiouny Alkholy, Mokhtar Abdirahman Kahin, Sary Mahmoud Wedinly, Rasha Mohammed Borini, Ayman Basardah, Gladsy Selva Livingston, Nooraldaem Yousif, Mohammed A. Qutub, Salman Saad Almalki, Ethan M. Ross, Abdullah Omair Alsuayri, Abdullah Al‐Enezi, Taher Hassan, M. Gabriel Khan, Hatem Aloui
article en
13 citations

Abstract

Background: There is a paucity of data regarding acute myocardial infarction (MI) complicated by cardiogenic shock (AMI-CS) in the Gulf region. This study addressed this knowledge gap by examining patients experiencing AMI-CS in the Gulf region and analyzing hospital and short-term follow-up mortality. Methods: The Gulf-Cardiogenic Shock registry included 1,513 patients with AMI-CS diagnosed between January 2020 and December 2022. Results: The incidence of AMI-CS was 4.1% (1,513/37,379). The median age was 60 years. The most common presentation was ST-elevation MI (73.83%). In-hospital mortality was 45.5%. Majority of patients were in SCAI (Society for Cardiovascular Angiography and Interventions shock classification) stage D and E (68.94%). Factors associated with hospital mortality were previous coronary artery bypass graft (odds ratio [OR]: 2.49; 95% confidence interval [CI]: 1.321-4.693), cerebrovascular accident (OR: 1.621; 95% CI: 1.032-2.547), chronic kidney disease (OR: 1.572; 95% CI: 1.158-2.136), non-ST-elevation MI (OR: 1.744; 95% CI: 1.058-2.873), cardiac arrest (OR: 5.702; 95% CI: 3.640-8.933), SCAI stage D and E (OR: 19.146; 95% CI: 9.902-37.017), prolonged QRS (OR: 10.012; 95% CI: 1.006-1.019), right ventricular dysfunction (OR: 1.679; 95% CI: 1.267-2.226), and ventricular septal rupture (OR: 6.008; 95% CI: 2.256-15.998). Forty percent had invasive hemodynamic monitoring, 90.02% underwent revascularization, and 45.80% received mechanical circulatory support (41.31% had intra-aortic balloon pump and 14.21% had extracorporeal membrane oxygenation/Impella devices). Survival at 12 months was 51.49% (95% CI: 46.44%-56.29%). Conclusions: The study highlighted the significant burden of AMI-CS in this region, with high in-hospital mortality. The study identified several key risk factors associated with increased hospital mortality. Despite the utilization of invasive hemodynamic monitoring, revascularization, and mechanical circulatory support in a substantial proportion of patients, the 12-month survival rate remained relatively low.

ShockVol. 62(4)
Cleveland Clinic (US), Baystate Medical Center (US), Alfaisal University (SA), Prince Sultan University (SA), University of Massachusetts Chan Medical School (US), King Abdulaziz University (SA), King Saud bin Abdulaziz University for Health Sciences (SA), Benha University (EG), Tanta University (EG), King Faisal Specialist Hospital & Research Centre (SA), King Saud Medical City (SA), Sultan Qaboos Hospital (OM), King Fahd Medical City (SA), King Saud University (SA), King Abdulaziz Medical City (SA), Amiri Hospital (KW), King Abdullah International Medical Research Center (SA), Bugshan Hospital (SA), Chest Diseases Hospital (KW), Saud Al-babtain Cardiac Centre (SA), Qatif Central Hospital (SA), Royal Hospital (OM), King Abdulaziz Hospital (SA), King Fahad Hospital Jeddah (SA), Islamic University of Madinah (SA), Elrazi University, National Guard Health Affairs (SA), Hamad Medical Corporation (QA), King Khalid University (SA)
Good health and well-being
Openalex Percentile: Top 2%
Cardiac Arrest and Resuscitation
8.98
DOISourceOpenAlex
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