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

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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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All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Kim, U., Park, J. S., Kang, S. W., Kim, Y. M., Park, W. J., Lee, S. H., Hong, G. R., Shin, D. G., Kim, Y. J., Jeong, M. H., Chae, S. C., Hur, S. H., Song, I. W., Hong, T. J., Chae, I. H., Cho, M. C., Jang, Y., Yoon, J., Seung, K. B., & Park, S. J. (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, 110(1), 36-39. https://doi.org/10.1016/j.amjcard.2012.02.044