The management of patients with cardiogenic shock

Sadowski, Marcin; Janion−Sadowska, Agnieszka

doi:10.5114/ms.2017.66959

Cited by 3 publications

(3 citation statements)

References 46 publications

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“…Our study confirmed again that short-and longterm outcomes in patients with acute myocardial infarction are highly dependent on initial circulatory status (e.g. Killip scale) [13] as well as comorbidities (Table 3).…”

Section: Discussionsupporting

confidence: 83%

The impact of ECG at admission and a culprit lesion on 12-month outcomes in acute myocardial infarction – analysis based on the PL-ACS Registry

Piątek,

Skrzypek

et al. 2023

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Introduction: Acute myocardial infarction (MI) is usually associated with ischaemic abnormalities in electrocardiography (ECG). However, a considerable proportion of MI cases present with no ischaemic changes (NIC). The exact impact of the ECG pattern and a culprit lesion on long-term outcomes in the era of routine percutaneous coronary interventions remains unclear.Aim of the research: To analyse baseline characteristics and 12-month outcomes of MI patients with various ECG patterns on admission as well as the exact impact of a culprit lesion on the long-term prognosis. Material and methods: Based on PL-ACS Registry data, we analysed patients admitted to Polish hospitals in 2015-2020 due to MI. A total of 111,689 cases who underwent primary percutaneous coronary intervention were included in the study. Based on initial ECG, 5 groups were established: ST segment elevation (STE), ST segment depression (STD), T-wave inversion (TWI), other ST-T abnormalities (STT), and no ischaemic changes (NIC). Results and conclusions: NIC patients accounted for over 10% of all MI cases. In-hospital mortality in NIC was higher than TWI but lower than in STE, STD, and STT. In 12-month follow-up NIC had worse prognosis than TWI and STE. STT and STD presented with the worst prognosis, which is associated with adverse factors like comorbidities, heart failure, and multi-vessel coronary disease. The impact of a culprit lesion on 12-month outcomes was equal for right coronary artery (RCA), obtuse marginal branch (OM), diagonal (D), and circumflex artery (Cx), i.e. it is negligible except for both LM and LAD. StreszczenieWprowadzenie: Ostry zawał serca (MI) jest zwykle związany z obecnością zmian niedokrwiennych w elektrokardiografii (EKG). Jednak u znaczącej grupy chorych z zawałem serca nie występują zmiany niedokrwienne (NIC). Znaczenie prognostyczne obrazu EKG oraz naczynia odpowiedzialnego za zawał na rokowanie długoterminowe w erze rutynowego stosowania przezskórnych interwencji wieńcowych jest niejasne. Cel pracy: Określenie charakterystyki klinicznej i 12-miesięcznego rokowania chorych z zawałem serca z różnymi wariantami EKG oraz ocena wpływu naczynia dozawałowego na długoterminową prognozę. Materiały i metody: Na podstawie danych z Rejestru PL-ACS przeanalizowano chorych z ostrym zawałem serca przyjętych do polskich szpitali w latach 2015-2020. Do badania włączono łącznie 111 689 chorych, którzy przebyli zabieg pierwotnej angioplastyki wieńcowej. Na podstawie obrazu EKG przy przyjęciu wyszczególniono 5 podgrup: uniesienie odcinka ST (STE), obniżenie odcinka ST (STD), odwrócenie załamków T (TWI), inne nieprawidłowości ST-T (STT) i brak zmian niedokrwiennych (NIC). Wyniki i wnioski: Grupa NIC stanowiła ponad 10% wszystkich przypadków zawału serca. Śmiertelność wewnątrzszpitalna w grupie NIC była niższa niż w TWI, ale wyższa niż w STE, STD i STT. W obserwacji 12-miesięcznej grupa NIC miała gorsze rokowanie niż TWI i STE. STT i STD charakteryzowały się najgorszym rokowaniem, co może się wiązać z niekorzystnymi czynnikami, takimi ja...

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Section: Discussionsupporting

confidence: 83%

The impact of ECG at admission and a culprit lesion on 12-month outcomes in acute myocardial infarction – analysis based on the PL-ACS Registry

Piątek,

Skrzypek

et al. 2023

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“…Although previous studies indicate that females after pPCI have more bleeding complications compared to men [22, 23], we did not observe such dependence after adjustment for age. Surprisingly, some complications in the studied group occurred less frequently than in the whole population of patients with STEMI, applying to FWR or VSD [24].…”

Section: Discussionmentioning

confidence: 99%

Gender-related differences in men and women with ST-segment elevation myocardial infarction and incomplete infarct-related artery flow restoration: a multicenter national registry

Zachura¹,

Wilczek²,

Kurzawski³

et al. 2018

pwki

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IntroductionLittle is known about gender-related differences in ST-segment elevation myocardial infarction (STEMI) and incomplete infarct-related artery (IRA) reperfusion after primary percutaneous coronary intervention (pPCI).AimTo evaluate gender-related differences in clinical characteristics and prognosis in patients with STEMI and incomplete IRA reperfusion after pPCI.Material and methodsFrom 42,752 STEMI patients hospitalized between 2009 and 2011 in Poland we analyzed a group of 984 (36%) females and 1,746 (64%) males with less than Thrombolysis in Myocardial Infarction (TIMI) grade 3 flow following pPCI.ResultsWomen were older than men (72.0 ±11.3 vs. 64.0 ±11.7 years; p < 0.0001) and in age-adjusted analysis they were more likely to present with hypertension (73.7% vs. 67%; p = 0.0003), diabetes (33% vs. 22.6%; p < 0.0001) and obesity (28.1% vs. 22.6%; p = 0.0016). Heart rate > 100 beats/min was more common in women, while men were more often smokers and presented with sudden cardiac arrest. The most common IRA in women was the left anterior descending artery, and the right coronary artery in men. After adjusting for age statistically significant differences in pharmacotherapy concerned only the use of insulin (OR = 1.31, 95% CI: 1.02–1.68). High risk of death, rehospitalization due to heart failure or cardiac causes, were observed in all patients during the 6-month and 12-month follow-up periods. The risk of heart failure was significantly higher in women than in men. The most significant decrease in survival rates was observed in the in-hospital period.ConclusionsAmong patients with STEMI and post-interventional TIMI flow grade < 3 women have unfavorable baseline characteristics and an adverse short- and long-term prognosis when compared to men.

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“…In general, metabolic syndrome (MetS) is defined as a collection of multiple risk factors including abdominal obesity, dyslipidaemia, abnormal glycaemia, and elevated blood pressure [1]. Metabolic syndrome is also associated with an increased risk of type 2 diabetes, cardiovascular morbidity, and mortality [2][3][4][5][6][7]. Furthermore, there is an association between MetS and increased total cancer mortality [8,9].…”

Section: Introductionmentioning

confidence: 99%

The roles of vaspin, chemerin, and omentin in the determination of metabolic syndrome

Suliga¹,

Wawszczak²,

Głuszek³

2018

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Metabolic syndrome (MetS) is defined as multiple risk factors including abdominal obesity, dyslipidaemia, abnormal glycaemia, and elevated blood pressure. The incidence of MetS and pathophysiological mechanisms underlying its development are still not fully understood. It is thought that the occurrence of MetS arises from the complex relationship between genetic and environmental factors. The aim of the study was to overview and summarise current knowledge regarding genetic determinants of MetS. Also analysed were the relationship between polymorphisms of the genes encoding selected adipokines (vaspin, chemerin, omentin) and the risk of MetS, as well as other metabolic disorders. The precise determination of MetS genotype is difficult because metabolic syndrome occurrence is a combination of multiple risk factors. A thorough understanding of pathomechanisms of MetS, involving selected adipokines, may in the future allow the use of these adipokines as potential biomarkers of metabolic disorder risk.

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The management of patients with cardiogenic shock

Cited by 3 publications

References 46 publications

The impact of ECG at admission and a culprit lesion on 12-month outcomes in acute myocardial infarction – analysis based on the PL-ACS Registry

The impact of ECG at admission and a culprit lesion on 12-month outcomes in acute myocardial infarction – analysis based on the PL-ACS Registry

Gender-related differences in men and women with ST-segment elevation myocardial infarction and incomplete infarct-related artery flow restoration: a multicenter national registry

The roles of vaspin, chemerin, and omentin in the determination of metabolic syndrome

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