Association of hemoglobin with incidence of in-hospital cardiac arrest in patients with acute coronary syndrome complicated by cardiogenic shock

Xu, Tiancheng; Liang, Dongjie; Wu, Shengjie; Zhou, Xiaodong; Shi, Ruiyu; Xiang, Wenhao; Zhou, Jian; Wang, Songjie; Shan, Peiren; Huang, Weijian

doi:10.1177/0300060519857021

Cited by 5 publications

(5 citation statements)

References 51 publications

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“…A study reported significantly higher incidence of CS among mild and severe electrolyte decline groups while reduction in electrolytes is also indicated to early demise as compared to normal [ 22 ]. Higher haemoglobin levels have been suggested as protective factor among acute cardiac syndrome patients having complications of CS is also in agreement with the findings of present study [ 23 ].…”

Section: Discussionsupporting

confidence: 93%

Cardiogenic Shock Among Patients with Acute Myocardial Infarction in a middle eastern Country: A Single-centre experience

Shalaby¹,

Niazi²,

Khaled³

2023

Journal of the Saudi Heart Association

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Background Cardiogenic Shock (CS) remains the most common cause of death in hospitalized acute ST-segment elevation myocardial infarction (STEMI) patients. Predictors of outcomes in those patients include clinical, laboratory, radiologic variables, and management strategies. The present study aimed to evaluate the incidence, characteristics, predictors of cardiogenic shock and mortality among acute ST-segment elevation myocardial infarction patients in our center. Methods This was a retrospective, single-center study conducted at KAMC, Makkah during 2015–2020. All acute ST-segment elevation myocardial infarction patients during this era were divided into two groups CS group and non-CS group. Results In this study total 3074 acute ST-segment elevation myocardial infarction patients of which 132(4.3%) patients had CS. CS group tended to have higher ages than non-CS group. Pilgrims were more complicated by CS than nonpilgrims. Subsequently, CS patients had a highly significant (p < 0.001 for all) increase in the incidence of in-hospital complications including pulmonary oedema, cardiac arrest and ventilation. There was a significant increase in hospital stay length and in-hospital mortality among CS patients. Renal impairment, peak troponin level, haemoglobin drop≥3 gm/dl, and Left ventricular ejection fraction (EF) were significant independent predictors of cardiogenic shock among our patients. However, STEMI type, left main disease, and EF was the independent predictors of CS among our patients with diabetes with EF cut-off value of 35% with a sensitivity of 74.6% and a specificity of 65.3%. Age was the only independent predictor of mortality among CS patients. Though age, female gender, and diabetes were found to be the independent predictors for in-hospital mortality among our patients. Conclusion High-income middle eastern countries have comparable outcomes to Europe and USA among patients with acute ST-segment elevation myocardial infarction patients with higher improvement of medical care in the last 2 to 3 decades. Renal impairment, peak troponin, severe bleeding and ejection fraction were significant independent predictors of CS in acute ST-segment elevation myocardial infarction patients. However, STEMI type, left main disease, and ejection fraction were the independent predictors of CS in acute ST-segment elevation myocardial infarction patients with diabetes. Age was the only independent predictor of mortality among CS patients.

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Section: Discussionsupporting

confidence: 93%

Cardiogenic Shock Among Patients with Acute Myocardial Infarction in a middle eastern Country: A Single-centre experience

Shalaby¹,

Niazi²,

Khaled³

2023

Journal of the Saudi Heart Association

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“…The association of hemoglobin levels and the risk of in-hospital cardiac arrest was elucidated upon by a number of studies. The multivariate analysis of a retrospective study of 211 consecutive patients with CS-AMI showed hemoglobin concentration under 112 g/L as an independent strong predictor of in-hospital cardiac arrest; in contrast, a 1-g/L increase in the hemoglobin levels indicated a 2.9% lower risk [ 42 ]. Therefore, the monitoring of hemoglobin levels could facilitate an early decision process.…”

Section: Resultsmentioning

confidence: 99%

“…The question is if this association is higher in younger patients. Underlying pathophysiological mechanisms were summarized by Xu et al Patients with anemia are more likely to develop ventricular arrhythmias, anemia induces tissue hypoxia in the ischemic regions and increases myocardial workload [ 42 ].…”

Section: Resultsmentioning

confidence: 99%

Laboratory Predictors of Prognosis in Cardiogenic Shock Complicating Acute Myocardial Infarction

Muzafarova

Motovska

2022

Biomedicines

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Cardiogenic shock is a state of reduced cardiac output leading to hypotension, pulmonary congestion, and hypoperfusion of tissues and vital organs. Despite the advances in intensive care over the last years, the morbidity and mortality of patients remain high. The available studies of patients with cardiogenic shock suggest a connection between clinical variables, the level of biomarkers, the results of imaging investigations, strategies of management and the outcome of this group of patients. The management of patients with cardiogenic shock initially complicating acute myocardial infarction is challenging, and the number of studies in this area is growing fast. The purpose of this review is to summarize the currently available evidence on cardiogenic shock initially complicating acute myocardial infarction with particular attention to predictors of prognosis, focusing on laboratory variables (established and new), and to discuss the practical implementation. Currently available scoring systems developed during the past few decades predict the clinical outcome of this group of patients using some of the established biomarkers among other variables. With the new laboratory biomarkers that have shown their predictive value in cardiogenic shock outcomes, a new design of scoring systems would be of interest. Identifying high-risk patients offers the opportunity for early decision-making.

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“…Among patients with ACS, studies have shown that lower hemoglobin levels on admission are an independent predictor of increased risk for short-term mortality, more so if complicated with comorbidities of hypertension or chronic renal disease ( 14 , 15 ). When complicated with CS, a higher hemoglobin concentration is a protective factor for the development of in-hospital cardiac arrest ( 16 ). Lastly, cardiac arrest patients with a prolonged CPR duration were observed to be associated with a poorer prognosis ( 17 , 18 ).…”

Section: Discussionmentioning

confidence: 99%

The CSP (Cardiogenic Shock Prognosis) Score: A Tool for Risk Stratification of Cardiogenic Shock

Tien

Chen

Huang

et al. 2022

Front. Cardiovasc. Med.

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BackgroundCardiogenic shock (CS) is a critical condition and the leading cause of mortality after acute myocardial infarction (AMI). Scores that predict mortality have been established, but a patient's clinical course is often nonlinear. Thus, factors present during acute care management may be explored. This study intended to develop a risk-predictive model for patients with CS.MethodsIn this observational study, adult patients who received inotropic support at the Emergency Room (ER) from January 2017 to August 2020 and were admitted to the cardiac care unit (CCU) with a diagnosis of CS were enrolled in this study. Patients with out-of-hospital cardiac arrest, inotropic support for bradycardia, and survival <24 h after ER arrival were excluded. A total of 311 patients were enrolled and categorized into derivation (n = 243) and validation (n = 68) cohorts.ResultsA history of coronary artery disease, multiple inotrope use, ejection fraction <40%, lower hemoglobin concentration, longer cardiopulmonary resuscitation duration, albumin infusion, and renal replacement therapy were identified as independent prognostic factors for in-hospital mortality. The cardiogenic shock prognosis (CSP) score was established as a nomogram and three risk groups were identified: low-risk (score 115, 0% of mortality), medium-risk (score 116–209, 8.75% of mortality), and high-risk (score 210, 66.67% of mortality). The area-under-the-curve (AUC) of the CSP score was 0.941, and the discrimination value in the validation cohort was consistent (AUC = 0.813).ConclusionsThe CSP score represents a risk-predictive model for in-hospital mortality in patients with CS in acute care settings. Patients identified as the high-risk category may have a poor prognosis.

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Association of hemoglobin with incidence of in-hospital cardiac arrest in patients with acute coronary syndrome complicated by cardiogenic shock

Cited by 5 publications

References 51 publications

Cardiogenic Shock Among Patients with Acute Myocardial Infarction in a middle eastern Country: A Single-centre experience

Cardiogenic Shock Among Patients with Acute Myocardial Infarction in a middle eastern Country: A Single-centre experience

Laboratory Predictors of Prognosis in Cardiogenic Shock Complicating Acute Myocardial Infarction

The CSP (Cardiogenic Shock Prognosis) Score: A Tool for Risk Stratification of Cardiogenic Shock

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