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  • Title: Comparison of early and long-term results of percutaneous coronary interventions in patients with ST elevation myocardial infarction, complicated or not by cardiogenic shock.
    Author: Lekston A, Slonka G, Gasior M, Pres D, Gierlotka M, Zebik T, Wasilewski J, Glowacki J, Polonski L.
    Journal: Coron Artery Dis; 2010 Jan; 21(1):13-9. PubMed ID: 19940765.
    Abstract:
    OBJECTIVES: Cardiogenic shock (CS) still remains one of the most important factors affecting the mortality rate of patients with ST segment elevation myocardial infarction (STEMI). However, the data with follow-up longer than 1 year are limited. The aim of this study was to evaluate the early and long-term treatment results of patients with STEMI, complicated or not by CS, who underwent percutaneus coronary interventions. METHODS: A retrospective registry included data of all patients with STEMI admitted to our centre from January 1999 to December 2001. RESULTS: One thousand three hundred and eighty-five patients with STEMI were hospitalized and 1237 of them were treated with immediate percutaneus coronary interventions. Among this subpopulation, 117 (9.5%) patients were with STEMI complicated with CS on admission (group I) and 1120 (90.5%) patients were with STEMI without complications from CS on admission (group II). The groups differed significantly with regard to baseline clinical characteristics, angiographic picture, and in-hospital course. A total of 38.5% of patients with myocardial infarction complicated by CS and 2.5% of patients without shock (P<0.001) died during hospitalization. At the 5-year follow-up, 58.1% of group I patients and 14.8% of group II patients (P<0.001) died. A significant difference in the 5-year mortality rate was also observed in patients who survived the in-hospital period (31.9 vs. 12.6%; P<0.001). CONCLUSION: CS continues to be closely connected with a very high mortality rate both in the hospital and in the long-term, also among patients who survived the in-hospital period.
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