Acute myocardial infarction complicated by shock: outcome analysis based on initial electrocardiogram*. (February 2014)

• Record Type: Journal Article
• Authors: Jakl, Martin; Stasek, Josef; Kala, Petr; Rokyta, Richard; Kanovsky, Jan; Ondrus, Tomas; Hromadka, Milan; Widimsky, Petr
• Is Part Of: Scandinavian cardiovascular journal. Volume 48:Number 1(2014:Feb.)
• Page Start: 13
• Page End: 19
• Publication Date: 2014-02
• Subjects: Cardiovascular system -- Diseases -- Periodicals; 617.41
• DOI: 10.3109/14017431.2013.865074
• Languages: English
• ISSNs: 1401-7431

Abstract

<abstract> <title>Abstract</title> <p> <italic>Objectives.</italic> To assess the relation between initial ECG findings, presence of risk factors, coronary angiography findings, and clinical outcomes in patients with acute myocardial infarction complicated by cardiogenic shock (CS). <italic>Design.</italic> Data from a total of 5572 acute myocardial infarction patients admitted to the four tertiary hospitals during a period of 3 years were analyzed. CS on admission was present in 358 patients (6.4%). They were divided into four groups based on the admission ECG: ST-segment elevation (STEMI), ST-segment depression (STDMI), bundle branch block (BBBMI), and other ECG acute myocardial infarction. <italic>Results.</italic> CS developed most frequently among BBBMI patients (in 12.1% of all BBBMIs, <italic>p</italic> < 0.001 vs. STEMI), followed by STEMI (6.7%), STDMI (4.4%), and other ECG acute myocardial infarction (2.3%). The risk of CS development was similar in patients with left bundle branch block (LBBB) (13.3%) and right bundle branch block (RBBB) (11.2%). The one-year mortality was highest among RBBBMI patients (66.7%, <italic>p</italic> < 0.001), followed by LBBBMI (48.6%), other ECG (47.1%), STEMI (41.7%), and STDMI patients (38.1%). <italic>Conclusions.</italic> RBBB on admission ECG is associated with the highest risk of CS development, frequent left main coronary artery affection, and unsuccessful revascularization. It is also an independent predictor of one-year mortality.</p> </abstract>