Tadeusz Zębik

Comparison of early and long-term results of percutaneous coronary interventions in patients with ST elevation myocardial infarction, complicated or not by cardiogenic shock.

ObjectivesCardiogenic 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. MethodsA retrospective registry included data of all patients with STEMI admitted to our centre from January 1999 to December 2001. ResultsOne 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). ConclusionCS 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.