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Acute myocardial infarction complicated by shock: outcome analysis based on initial electrocardiogram

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JAKL Martin STASEK Josef KALA Petr ROKYTA Richard KAŇOVSKÝ Jan ONDRÚŠ Tomáš HROMADKA Milan WIDIMSKY Petr

Rok publikování 2014
Druh Článek v odborném periodiku
Časopis / Zdroj SCANDINAVIAN CARDIOVASCULAR JOURNAL
Fakulta / Pracoviště MU

Lékařská fakulta

Citace
Doi http://dx.doi.org/10.3109/14017431.2013.865074
Obor Kardiovaskulární nemoci včetně kardiochirurgie
Klíčová slova cardiogenic shock; coronary angiography; electrocardiography; mortality; myocardial infarction; percutaneous coronary intervention
Popis Objectives. 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). Design. 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. Results. CS developed most frequently among BBBMI patients (in 12.1% of all BBBMIs, p < 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%, p < 0.001), followed by LBBBMI (48.6%), other ECG (47.1%), STEMI (41.7%), and STDMI patients (38.1%). Conclusions. 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.

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