Outcomes according to presentation with versus without cardiogenic shock in patients with left main coronary artery stenosis and acute myocardial infarction

Ung Kim, Jong Seon Park, Sang Wook Kang, You Min Kim, Won Jong Park, Sang Hee Lee, Geu Ru Hong, Dong Gu Shin, Young Jo Kim, Myung Ho Jeong, Shung Chull Chae, Seung Ho Hur, In Whan Song, Taek Jong Hong, In Ho Chae, Myeong Chan Cho, Yangsoo Jang, Junghan Yoon, Ki Bae Seung, Seung Jung Park

Research output: Contribution to journalArticle

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Abstract

This study is aimed at evaluating 1-year clinical outcomes and their predictors in patients with unprotected left main coronary artery (ULMCA)-related acute myocardial infarction (AMI). In total 248 patients diagnosed with AMI involving the ULMCA as the culprit vessel and registered in the Korean Acute Myocardial Infarction database were enrolled in this study. Patients were divided according to the absence (shock-, n = 206) or presence (shock+, n = 42) of cardiogenic shock at initial presentation. Independent risk factors of in-hospital cardiac death associated with ULMCA-related AMI were elucidated by multivariate regression analysis. In-hospital mortality rates were 8.7% in the shock- group and 47.6% in the shock+ group (p = 0.001). During 1-year follow-up after discharge, major adverse cardiac events developed in 16.3% of patients in the shock- group and 18.2% of patients in the shock+ group (p = 0.828); cardiac death, MI, and ischemia-driven target vessel revascularization were similar between the 2 groups at 1 year. On multivariate analysis, initial shock presentation (odds ratio 8.9, confidence interval 4.1 to 19.2, p = 0.004) and left ventricular ejection fraction <30% (odds ratio 7.6, confidence interval 2.7 to 21.1, p = 0.001) were independent risk factors of in-hospital cardiac death associated with ULMCA-related AMI. In conclusion, almost 1/2 of patients with ULMCA-related AMI presenting with cardiogenic shock had a fatal in-hospital outcome compared to <10% of those without cardiogenic shock; however, clinical outcomes after survival of the in-hospital period were not different between these groups.

Original languageEnglish
Pages (from-to)36-39
Number of pages4
JournalAmerican Journal of Cardiology
Volume110
Issue number1
DOIs
Publication statusPublished - 2012 Jul 1

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Cardiogenic Shock
Coronary Stenosis
Shock
Myocardial Infarction
Coronary Vessels
Multivariate Analysis
Odds Ratio
Confidence Intervals
Hospital Mortality
Stroke Volume
Ischemia
Regression Analysis
Databases
Survival
Mortality

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Kim, Ung ; Park, Jong Seon ; Kang, Sang Wook ; Kim, You Min ; Park, Won Jong ; Lee, Sang Hee ; Hong, Geu Ru ; Shin, Dong Gu ; Kim, Young Jo ; Jeong, Myung Ho ; Chae, Shung Chull ; Hur, Seung Ho ; Song, In Whan ; Hong, Taek Jong ; Chae, In Ho ; Cho, Myeong Chan ; Jang, Yangsoo ; Yoon, Junghan ; Seung, Ki Bae ; Park, Seung Jung. / Outcomes according to presentation with versus without cardiogenic shock in patients with left main coronary artery stenosis and acute myocardial infarction. In: American Journal of Cardiology. 2012 ; Vol. 110, No. 1. pp. 36-39.
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title = "Outcomes according to presentation with versus without cardiogenic shock in patients with left main coronary artery stenosis and acute myocardial infarction",
abstract = "This study is aimed at evaluating 1-year clinical outcomes and their predictors in patients with unprotected left main coronary artery (ULMCA)-related acute myocardial infarction (AMI). In total 248 patients diagnosed with AMI involving the ULMCA as the culprit vessel and registered in the Korean Acute Myocardial Infarction database were enrolled in this study. Patients were divided according to the absence (shock-, n = 206) or presence (shock+, n = 42) of cardiogenic shock at initial presentation. Independent risk factors of in-hospital cardiac death associated with ULMCA-related AMI were elucidated by multivariate regression analysis. In-hospital mortality rates were 8.7{\%} in the shock- group and 47.6{\%} in the shock+ group (p = 0.001). During 1-year follow-up after discharge, major adverse cardiac events developed in 16.3{\%} of patients in the shock- group and 18.2{\%} of patients in the shock+ group (p = 0.828); cardiac death, MI, and ischemia-driven target vessel revascularization were similar between the 2 groups at 1 year. On multivariate analysis, initial shock presentation (odds ratio 8.9, confidence interval 4.1 to 19.2, p = 0.004) and left ventricular ejection fraction <30{\%} (odds ratio 7.6, confidence interval 2.7 to 21.1, p = 0.001) were independent risk factors of in-hospital cardiac death associated with ULMCA-related AMI. In conclusion, almost 1/2 of patients with ULMCA-related AMI presenting with cardiogenic shock had a fatal in-hospital outcome compared to <10{\%} of those without cardiogenic shock; however, clinical outcomes after survival of the in-hospital period were not different between these groups.",
author = "Ung Kim and Park, {Jong Seon} and Kang, {Sang Wook} and Kim, {You Min} and Park, {Won Jong} and Lee, {Sang Hee} and Hong, {Geu Ru} and Shin, {Dong Gu} and Kim, {Young Jo} and Jeong, {Myung Ho} and Chae, {Shung Chull} and Hur, {Seung Ho} and Song, {In Whan} and Hong, {Taek Jong} and Chae, {In Ho} and Cho, {Myeong Chan} and Yangsoo Jang and Junghan Yoon and Seung, {Ki Bae} and Park, {Seung Jung}",
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Kim, U, Park, JS, Kang, SW, Kim, YM, Park, WJ, Lee, SH, Hong, GR, Shin, DG, Kim, YJ, Jeong, MH, Chae, SC, Hur, SH, Song, IW, Hong, TJ, Chae, IH, Cho, MC, Jang, Y, Yoon, J, Seung, KB & Park, SJ 2012, 'Outcomes according to presentation with versus without cardiogenic shock in patients with left main coronary artery stenosis and acute myocardial infarction', American Journal of Cardiology, vol. 110, no. 1, pp. 36-39. https://doi.org/10.1016/j.amjcard.2012.02.044

Outcomes according to presentation with versus without cardiogenic shock in patients with left main coronary artery stenosis and acute myocardial infarction. / Kim, Ung; Park, Jong Seon; Kang, Sang Wook; Kim, You Min; Park, Won Jong; Lee, Sang Hee; Hong, Geu Ru; Shin, Dong Gu; Kim, Young Jo; Jeong, Myung Ho; Chae, Shung Chull; Hur, Seung Ho; Song, In Whan; Hong, Taek Jong; Chae, In Ho; Cho, Myeong Chan; Jang, Yangsoo; Yoon, Junghan; Seung, Ki Bae; Park, Seung Jung.

In: American Journal of Cardiology, Vol. 110, No. 1, 01.07.2012, p. 36-39.

Research output: Contribution to journalArticle

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AU - Park, Jong Seon

AU - Kang, Sang Wook

AU - Kim, You Min

AU - Park, Won Jong

AU - Lee, Sang Hee

AU - Hong, Geu Ru

AU - Shin, Dong Gu

AU - Kim, Young Jo

AU - Jeong, Myung Ho

AU - Chae, Shung Chull

AU - Hur, Seung Ho

AU - Song, In Whan

AU - Hong, Taek Jong

AU - Chae, In Ho

AU - Cho, Myeong Chan

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AU - Park, Seung Jung

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N2 - This study is aimed at evaluating 1-year clinical outcomes and their predictors in patients with unprotected left main coronary artery (ULMCA)-related acute myocardial infarction (AMI). In total 248 patients diagnosed with AMI involving the ULMCA as the culprit vessel and registered in the Korean Acute Myocardial Infarction database were enrolled in this study. Patients were divided according to the absence (shock-, n = 206) or presence (shock+, n = 42) of cardiogenic shock at initial presentation. Independent risk factors of in-hospital cardiac death associated with ULMCA-related AMI were elucidated by multivariate regression analysis. In-hospital mortality rates were 8.7% in the shock- group and 47.6% in the shock+ group (p = 0.001). During 1-year follow-up after discharge, major adverse cardiac events developed in 16.3% of patients in the shock- group and 18.2% of patients in the shock+ group (p = 0.828); cardiac death, MI, and ischemia-driven target vessel revascularization were similar between the 2 groups at 1 year. On multivariate analysis, initial shock presentation (odds ratio 8.9, confidence interval 4.1 to 19.2, p = 0.004) and left ventricular ejection fraction <30% (odds ratio 7.6, confidence interval 2.7 to 21.1, p = 0.001) were independent risk factors of in-hospital cardiac death associated with ULMCA-related AMI. In conclusion, almost 1/2 of patients with ULMCA-related AMI presenting with cardiogenic shock had a fatal in-hospital outcome compared to <10% of those without cardiogenic shock; however, clinical outcomes after survival of the in-hospital period were not different between these groups.

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