Predictors of Outcomes in Myocardial Infarction and Cardiogenic Shock

Acharya, Deepak

doi:10.1097/crd.0000000000000190

Cited by 65 publications

(62 citation statements)

References 162 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These findings are in line with previous reports which showed that CS patients represent a high-risk group for the development of MA (Gorenek et al, 2015). Moreover, a reduced EF and the occurrence of MA are known risk factors for mortality in patients after myocardial infarction (Askari et al, 2009;Acharya, 2018). All included patients were admitted to the ICU with clinical signs of end-organ hypoperfusion, low CI, and the need of catecholamines for circulatory support.…”

Section: Discussionsupporting

confidence: 88%

Malignant Arrhythmias During Induction of Target Temperature Management After Cardiac Arrest

Adler

Schregel

Heller

et al. 2020

Therapeutic Hypothermia and Temperature Management

View full text Add to dashboard Cite

The aim of this study was to evaluate the incidence and determinants of malignant arrhythmias (MA) in patients with shock following out-of-hospital cardiac arrest (OHCA) treated with targeted temperature management. Risk factors for the development of MA were prospectively analyzed in patients after OHCA. MA were defined as ventricular tachycardia or fibrillation with a duration >30 seconds, which had to be terminated by defibrillation. All patients were treated with therapeutic hypothermia for 24 hours. Demographics, OHCA details, interventions, and intensive care unit (ICU) treatment were recorded. A total of 55 patients were included, 11 (20%) of whom developed MA during the ICU stay. All MA occurred within the first 18 hours after admission. Patients who developed MA showed a stronger decrease in body temperature (D-2.4°C-0.8°C vs. D-1.3°C-1.3°C; p = 0.016) and in serum potassium levels (D-0.9-1 mmol/L vs. D-0.3-0.6 mmol/L; p = 0.037) during the cooling period compared with patients without MA. In the multivariable analysis, fast temperature decline as well as lower potassium levels were associated with MA. In addition, higher number of shocks during resuscitation and higher ICU epinephrine use were independent predictors of MA in patients with OHCA. The use of epinephrine as well as hypokalemia in context with intense cooling may increase the incidence of MA in patients with shock after cardiac arrest. Therefore, these therapeutic strategies should be applied with caution in this vulnerable group of patients.

show abstract

Section: Discussionsupporting

confidence: 88%

Malignant Arrhythmias During Induction of Target Temperature Management After Cardiac Arrest

Adler

Schregel

Heller

et al. 2020

Therapeutic Hypothermia and Temperature Management

View full text Add to dashboard Cite

show abstract

“…However, the severity of CS after AMI and clinical outcome vary greatly [1][2][3][4][5][6]. Whilst patients over 75 years of age are at highest risk of CS and death [7,9], this cohort may still benefi t from aggressive management when appropriate [9].…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, 80% of the deaths due to AMI occurs in those over 65 years of age and 60% of the mortality in this cohort occurs in those over 75 years old [8]. Increasing age is associated with higher risk of developing CS after AMI [7,9]. Although elderly patients are at higher risk, they may still benefi t from aggressive treatment of CS [9].…”

Section: Introductionmentioning

confidence: 98%

See 1 more Smart Citation

Risk stratification to guide management in cardiogenic shock due to acute myocardial infarction. An illustrative case series and review of the literature

Rajendram¹

2020

J Cardiovasc Med Cardiol

View full text Add to dashboard Cite

show abstract

“…Although there have been great improvements in pharmacological treatment and reperfusion therapy of patients with CS in the last two decades, the mortality rate among these patients still remains to be high (16). Additionally, this condition is frequently complicated with the deterioration of renal functions that has been related with further increase in mortality rates (17,18). Hence, adequate intravenous hydration, timely start of continuous renal replacement therapy, and mechanical circulatory support would be crucial steps after identification of these patients.…”

Section: Discussionmentioning

confidence: 99%

The Prognostic Value of GRACE score for Acute Kidney injury in ST Elevation Myocardial Infarction Patients Complicated with Cardiogenic Shock

Çınar¹

2019

Erciyes Med J

View full text Add to dashboard Cite

Objective: The Global Registry of Acute Coronary Events (GRACE) risk score has been proposed in predicting short-term death in patients who are diagnosed with acute coronary syndrome. The aim of the present study was to investigate the significance of the GRACE score for acute kidney injury (AKI) in patients with cardiogenic shock (CS)-ST elevation myocardial infarction (STEMI) who were treated with primary percutaneous coronary intervention (PPCI). Materials and Methods: We retrospectively examined a total of 492 consecutive patients with CS-STEMI who had undergone PPCI. The GRACE score was calculated for each patient. Patients were stratified by tertiles (T1, T2, and T3) according to the GRACE score, and the incidence of AKI was compared between the groups. Results: In univariate analysis, the incidence of AKI was significantly higher for patients allocated into the T3 group than for patients in the T1 group (odds ratio (OR) 2.8, 95% confidence interval (CI) 1.8-4.1, p<0.001). Following including all confounding variables, participants in the T3 group had a 3.1-fold higher incidence of AKI (OR 3.1, 95% CI 1.9-5.4, p<0.001). In a receiver operating characteristic curve analysis, the GRACE score of the area under the curve value for AKI was 0.70 (95% CI 0.65-0.74, p<0.001) with 69.2% sensitivity and 68.8% specificity. Conclusion: The GRACE score provides an independent prognostic marker of AKI in patients with CS related with STEMI. Based on our data, we propose that the GRACE score is a simple and clinically applicable directive tool for rapid risk stratification of AKI in patients with STEMI complicated with CS.

show abstract

Predictors of Outcomes in Myocardial Infarction and Cardiogenic Shock

Cited by 65 publications

References 162 publications

Malignant Arrhythmias During Induction of Target Temperature Management After Cardiac Arrest

Malignant Arrhythmias During Induction of Target Temperature Management After Cardiac Arrest

Risk stratification to guide management in cardiogenic shock due to acute myocardial infarction. An illustrative case series and review of the literature

The Prognostic Value of GRACE score for Acute Kidney injury in ST Elevation Myocardial Infarction Patients Complicated with Cardiogenic Shock

Contact Info

Product

Resources

About