Cardiac arrest at presentation (OR 7.06, P=0.014), higher SCAI shock stage (OR 3.78, P<0.001), and RV dysfunction (OR 2.89, P=0.048) independently predicted in-hospital mortality in AMI-CS.
Cohort (n=95)
No
Cardiac arrest at presentation, advanced SCAI shock stage, and right ventricular dysfunction are strong independent predictors of in-hospital mortality in patients with AMI-CS.
Effect estimate: OR 7.06
p-value: p=0.014
ABSTRACT Background: Cardiogenic shock (CS) is a prevalent severe complication of acute myocardial infarction (AMI) with high in-hospital mortality despite advances in medical and interventional therapies. Identifying prognostic factors are essential for improving survival outcomes. Objectives: This study aims to evaluate clinical, laboratory, and management-related predictors of survival in patients with AMI-CS. Subjects and Methods: This retrospective cohort study investigated 95 patients presented with AMI-CS at King Abdulaziz University Hospital between 2020 and 2022, with an 18-month follow-up. Patients were classified into survivors ( n = 38) and nonsurvivors ( n = 57). Demographic data, clinical, laboratory parameters, echocardiographic findings, management strategies, and outcomes were assessed. Logistic regression analysis was conducted to identify independent predictors of in-hospital mortality. Results: The overall in-hospital mortality rate was 60%. Independent predictors of mortality included cardiac arrest at presentation (odds ratio OR = 7.06, P = 0.014), higher Society for Cardiovascular Angiography and Interventions (SCAI) shock stage (OR = 3.78, P < 0.001), and right ventricular (RV) dysfunction (OR = 2.89, P = 0.048). Conversely, higher body mass index (BMI) (OR = 0.90, P = 0.06) and right coronary artery (RCA) as the culprit lesion (OR = 0.51, P = 0.028) were associated with improved survival. Kaplan–Meier analysis showed that survival rates at 6, 12, and 18 months were 60%, 43%, and 27%, respectively, with significantly lower survival in patients with advanced SCAI shock stages. Conclusions: In patients with AMI-CS, cardiac arrest, advanced SCAI shock stage, and RV dysfunction serve as key predictors of in-hospital mortality, while higher BMI and culprit RCA were associated with better survival. These findings underscore the need for early risk stratification and targeted management strategies to improve outcomes in AMI-CS patients.
Mohammed A. Qutub (Wed,) conducted a cohort in Cardiogenic shock secondary to acute myocardial infarction (n=95). Prognostic factors (cardiac arrest, SCAI shock stage, RV dysfunction, BMI, culprit RCA) was evaluated on In-hospital mortality (OR 7.06, p=0.014). Cardiac arrest at presentation (OR 7.06, P=0.014), higher SCAI shock stage (OR 3.78, P<0.001), and RV dysfunction (OR 2.89, P=0.048) independently predicted in-hospital mortality in AMI-CS.