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

Abstract

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.

Predictive value of the baseline electrocardiogram ST‐segment pattern in cardiogenic shock: Results from the CardShock Study

“…This finding is in accordance with earlier studies, as greater burden of coronary artery disease has been associated with an increased risk of CS in STEMI patients (Obling et al, 2017). An STDEP was associated with three-vessel disease, as previously depicted (Anderson et al, 2013;Holmes et al, 1999;Jacobs et al, 2000;Jakl et al, 2014), but the prevalence of the left main coronary artery disease was similar in the STE and STDEP groups, in contrast to earlier studies (Jacobs et al, 2000).…”

“…In the ACS subgroup analysis, the ST‐segment deviations were not associated with mortality, corresponding to some earlier studies (Jacobs et al, ; Jakl et al, ). However, the previous data is inconsistent; some contemporary studies have reported opposite results, where the prognosis of NSTEMI has been inferior to the prognosis of STEMI (Anderson et al, ; Jeger et al, ).…”

“…Furthermore, the results of the earlier studies are inconsistent in ACS-related CS; some have suggested a higher mortality in patients with non-STE myocardial infarction (NSTEMI; Anderson et al, 2013;Holmes et al, 1999;Jeger et al, 2008), while others have found no differences in the mortality (Jacobs et al, 2000;Jakl et al, 2014).…”

“…Previously, ST‐segment deviations have only been investigated in patients with ACS aetiology, excluding the patients with other CS aetiologies. Furthermore, the results of the earlier studies are inconsistent in ACS‐related CS; some have suggested a higher mortality in patients with non‐STE myocardial infarction (NSTEMI; Anderson et al, ; Holmes et al, ; Jeger et al, ), while others have found no differences in the mortality (Jacobs et al, ; Jakl et al, ).…”

Prevalence, Temporal Evolution, and Impact on Survival of Ventricular Conduction Blocks in Patients With Acute Coronary Syndrome and Cardiogenic Shock

“…Cardiogenic shock (CS) is the most severe complication of acute myocardial infarction (AMI) and is associated with high short-term mortality, despite advances in reperfusion therapy and modern intensive care 1,2 . In AMI, the incidence of CS increases from 5-8% up to 12-19% in the presence of a bundle branch block 1,[3][4][5] , especially with right bundle branch block (RBBB) 5,6 . Changes in the QRS duration and pattern in addition to ST segment deviations are regarded to reflect more severe ischemia and faster progression of irreversible myocardial necrosis than ST segment deviations alone 7,8 .…”