Angiographic findings and clinical correlates in patients with cardiogenic shock complicating acute myocardial infarction: A report from the SHOCK Trial Registry

S. Chiu Wong, Timothy Sanborn, Lynn A. Sleeper, John G. Webb, Robert Pilchik, David Hart, Slawomir Mejnartowicz, Tracy A. Antonelli, Richard Lange, John K. French, Geoffrey Bergman, Thierry LeJemtel, Judith S. Hochman

Research output: Contribution to journalArticle

Abstract

OBJECTIVES: We sought to delineate the angiographic findings, clinical correlates and in-hospital outcomes in patients with cardiogenic shock (CS) complicating acute myocardial infarction. BACKGROUND: Patients with CS complicating acute myocardial infarction carry a grave prognosis. Detailed angiographic findings in a large, prospectively identified cohort of patients with CS are currently lacking. METHODS: We compared the clinical characteristics, angiographic findings, and in-hospital outcomes of 717 patients selected to undergo angiography and 442 not selected, overall and by shock etiology: left or right ventricular failure versus mechanical complications. RESULTS: Patients who underwent angiography had lower baseline risk and a better hemodynamic profile than those who did not. Overall, 15.5% of the patients had significant left main lesions on angiography, and 53.4% had three-vessel disease, with higher rates of both for those with ventricular failure, compared with patients who had mechanical complications. Among patients who underwent angiography, those with ventricular failure had significantly lower in-hospital mortality than patients with mechanical complications (45.2% vs. 57.0%; p = 0.021). Importantly, for patients with ventricular failure, in-hospital mortality also correlated with disease severity: 35.0% for no or single-vessel disease versus 50.8% for three-vessel disease. Furthermore, mortality was associated with the culprit lesion location (78.6% in left main lesion, 69.7% in saphenous vein graft lesions, 42.4% in circumflex lesions, 42.3% in left anterior descending lesions, and 37.4% in right coronary artery lesions), and Thrombolysis In Myocardial Infarction (TIMI) flow grade (46.5% in TIMI 0/1, 49.4% in TIMI 2 and 26% in TIMI 3). CONCLUSIONS: Patients who underwent angiographic study in the SHOCK Trial Registry had a more benign cardiac risk profile, more favorable hemodynamic findings and lower in-hospital mortality than those for whom angiograms were not obtained. Patients with CS caused by ventricular failure had more severe atherosclerosis, and a different distribution of culprit vessel involvement but lower in-hospital mortality, than those with mechanical complications. Overall in-hospital survival correlates with the extent of coronary artery obstructions, location of culprit lesion and baseline coronary TIMI flow grade. (C) 2000 by the American College of Cardiology.

Original languageEnglish (US)
Pages (from-to)1077-1083
Number of pages7
JournalJournal of the American College of Cardiology
Volume36
Issue number3 SUPPL. A
DOIs
StatePublished - 2000
Externally publishedYes

Fingerprint

Cardiogenic Shock
Registries
Myocardial Infarction
Angiography
Hospital Mortality
Coronary Vessels
Hemodynamics
Saphenous Vein
Shock
Atherosclerosis

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Angiographic findings and clinical correlates in patients with cardiogenic shock complicating acute myocardial infarction : A report from the SHOCK Trial Registry. / Wong, S. Chiu; Sanborn, Timothy; Sleeper, Lynn A.; Webb, John G.; Pilchik, Robert; Hart, David; Mejnartowicz, Slawomir; Antonelli, Tracy A.; Lange, Richard; French, John K.; Bergman, Geoffrey; LeJemtel, Thierry; Hochman, Judith S.

In: Journal of the American College of Cardiology, Vol. 36, No. 3 SUPPL. A, 2000, p. 1077-1083.

Research output: Contribution to journalArticle

Wong, SC, Sanborn, T, Sleeper, LA, Webb, JG, Pilchik, R, Hart, D, Mejnartowicz, S, Antonelli, TA, Lange, R, French, JK, Bergman, G, LeJemtel, T & Hochman, JS 2000, 'Angiographic findings and clinical correlates in patients with cardiogenic shock complicating acute myocardial infarction: A report from the SHOCK Trial Registry', Journal of the American College of Cardiology, vol. 36, no. 3 SUPPL. A, pp. 1077-1083. https://doi.org/10.1016/S0735-1097(00)00873-1
Wong, S. Chiu ; Sanborn, Timothy ; Sleeper, Lynn A. ; Webb, John G. ; Pilchik, Robert ; Hart, David ; Mejnartowicz, Slawomir ; Antonelli, Tracy A. ; Lange, Richard ; French, John K. ; Bergman, Geoffrey ; LeJemtel, Thierry ; Hochman, Judith S. / Angiographic findings and clinical correlates in patients with cardiogenic shock complicating acute myocardial infarction : A report from the SHOCK Trial Registry. In: Journal of the American College of Cardiology. 2000 ; Vol. 36, No. 3 SUPPL. A. pp. 1077-1083.
@article{9dc98e03d19344e1b780d2662e9ed0ac,
title = "Angiographic findings and clinical correlates in patients with cardiogenic shock complicating acute myocardial infarction: A report from the SHOCK Trial Registry",
abstract = "OBJECTIVES: We sought to delineate the angiographic findings, clinical correlates and in-hospital outcomes in patients with cardiogenic shock (CS) complicating acute myocardial infarction. BACKGROUND: Patients with CS complicating acute myocardial infarction carry a grave prognosis. Detailed angiographic findings in a large, prospectively identified cohort of patients with CS are currently lacking. METHODS: We compared the clinical characteristics, angiographic findings, and in-hospital outcomes of 717 patients selected to undergo angiography and 442 not selected, overall and by shock etiology: left or right ventricular failure versus mechanical complications. RESULTS: Patients who underwent angiography had lower baseline risk and a better hemodynamic profile than those who did not. Overall, 15.5{\%} of the patients had significant left main lesions on angiography, and 53.4{\%} had three-vessel disease, with higher rates of both for those with ventricular failure, compared with patients who had mechanical complications. Among patients who underwent angiography, those with ventricular failure had significantly lower in-hospital mortality than patients with mechanical complications (45.2{\%} vs. 57.0{\%}; p = 0.021). Importantly, for patients with ventricular failure, in-hospital mortality also correlated with disease severity: 35.0{\%} for no or single-vessel disease versus 50.8{\%} for three-vessel disease. Furthermore, mortality was associated with the culprit lesion location (78.6{\%} in left main lesion, 69.7{\%} in saphenous vein graft lesions, 42.4{\%} in circumflex lesions, 42.3{\%} in left anterior descending lesions, and 37.4{\%} in right coronary artery lesions), and Thrombolysis In Myocardial Infarction (TIMI) flow grade (46.5{\%} in TIMI 0/1, 49.4{\%} in TIMI 2 and 26{\%} in TIMI 3). CONCLUSIONS: Patients who underwent angiographic study in the SHOCK Trial Registry had a more benign cardiac risk profile, more favorable hemodynamic findings and lower in-hospital mortality than those for whom angiograms were not obtained. Patients with CS caused by ventricular failure had more severe atherosclerosis, and a different distribution of culprit vessel involvement but lower in-hospital mortality, than those with mechanical complications. Overall in-hospital survival correlates with the extent of coronary artery obstructions, location of culprit lesion and baseline coronary TIMI flow grade. (C) 2000 by the American College of Cardiology.",
author = "Wong, {S. Chiu} and Timothy Sanborn and Sleeper, {Lynn A.} and Webb, {John G.} and Robert Pilchik and David Hart and Slawomir Mejnartowicz and Antonelli, {Tracy A.} and Richard Lange and French, {John K.} and Geoffrey Bergman and Thierry LeJemtel and Hochman, {Judith S.}",
year = "2000",
doi = "10.1016/S0735-1097(00)00873-1",
language = "English (US)",
volume = "36",
pages = "1077--1083",
journal = "Journal of the American College of Cardiology",
issn = "0735-1097",
publisher = "Elsevier USA",
number = "3 SUPPL. A",

}

TY - JOUR

T1 - Angiographic findings and clinical correlates in patients with cardiogenic shock complicating acute myocardial infarction

T2 - A report from the SHOCK Trial Registry

AU - Wong, S. Chiu

AU - Sanborn, Timothy

AU - Sleeper, Lynn A.

AU - Webb, John G.

AU - Pilchik, Robert

AU - Hart, David

AU - Mejnartowicz, Slawomir

AU - Antonelli, Tracy A.

AU - Lange, Richard

AU - French, John K.

AU - Bergman, Geoffrey

AU - LeJemtel, Thierry

AU - Hochman, Judith S.

PY - 2000

Y1 - 2000

N2 - OBJECTIVES: We sought to delineate the angiographic findings, clinical correlates and in-hospital outcomes in patients with cardiogenic shock (CS) complicating acute myocardial infarction. BACKGROUND: Patients with CS complicating acute myocardial infarction carry a grave prognosis. Detailed angiographic findings in a large, prospectively identified cohort of patients with CS are currently lacking. METHODS: We compared the clinical characteristics, angiographic findings, and in-hospital outcomes of 717 patients selected to undergo angiography and 442 not selected, overall and by shock etiology: left or right ventricular failure versus mechanical complications. RESULTS: Patients who underwent angiography had lower baseline risk and a better hemodynamic profile than those who did not. Overall, 15.5% of the patients had significant left main lesions on angiography, and 53.4% had three-vessel disease, with higher rates of both for those with ventricular failure, compared with patients who had mechanical complications. Among patients who underwent angiography, those with ventricular failure had significantly lower in-hospital mortality than patients with mechanical complications (45.2% vs. 57.0%; p = 0.021). Importantly, for patients with ventricular failure, in-hospital mortality also correlated with disease severity: 35.0% for no or single-vessel disease versus 50.8% for three-vessel disease. Furthermore, mortality was associated with the culprit lesion location (78.6% in left main lesion, 69.7% in saphenous vein graft lesions, 42.4% in circumflex lesions, 42.3% in left anterior descending lesions, and 37.4% in right coronary artery lesions), and Thrombolysis In Myocardial Infarction (TIMI) flow grade (46.5% in TIMI 0/1, 49.4% in TIMI 2 and 26% in TIMI 3). CONCLUSIONS: Patients who underwent angiographic study in the SHOCK Trial Registry had a more benign cardiac risk profile, more favorable hemodynamic findings and lower in-hospital mortality than those for whom angiograms were not obtained. Patients with CS caused by ventricular failure had more severe atherosclerosis, and a different distribution of culprit vessel involvement but lower in-hospital mortality, than those with mechanical complications. Overall in-hospital survival correlates with the extent of coronary artery obstructions, location of culprit lesion and baseline coronary TIMI flow grade. (C) 2000 by the American College of Cardiology.

AB - OBJECTIVES: We sought to delineate the angiographic findings, clinical correlates and in-hospital outcomes in patients with cardiogenic shock (CS) complicating acute myocardial infarction. BACKGROUND: Patients with CS complicating acute myocardial infarction carry a grave prognosis. Detailed angiographic findings in a large, prospectively identified cohort of patients with CS are currently lacking. METHODS: We compared the clinical characteristics, angiographic findings, and in-hospital outcomes of 717 patients selected to undergo angiography and 442 not selected, overall and by shock etiology: left or right ventricular failure versus mechanical complications. RESULTS: Patients who underwent angiography had lower baseline risk and a better hemodynamic profile than those who did not. Overall, 15.5% of the patients had significant left main lesions on angiography, and 53.4% had three-vessel disease, with higher rates of both for those with ventricular failure, compared with patients who had mechanical complications. Among patients who underwent angiography, those with ventricular failure had significantly lower in-hospital mortality than patients with mechanical complications (45.2% vs. 57.0%; p = 0.021). Importantly, for patients with ventricular failure, in-hospital mortality also correlated with disease severity: 35.0% for no or single-vessel disease versus 50.8% for three-vessel disease. Furthermore, mortality was associated with the culprit lesion location (78.6% in left main lesion, 69.7% in saphenous vein graft lesions, 42.4% in circumflex lesions, 42.3% in left anterior descending lesions, and 37.4% in right coronary artery lesions), and Thrombolysis In Myocardial Infarction (TIMI) flow grade (46.5% in TIMI 0/1, 49.4% in TIMI 2 and 26% in TIMI 3). CONCLUSIONS: Patients who underwent angiographic study in the SHOCK Trial Registry had a more benign cardiac risk profile, more favorable hemodynamic findings and lower in-hospital mortality than those for whom angiograms were not obtained. Patients with CS caused by ventricular failure had more severe atherosclerosis, and a different distribution of culprit vessel involvement but lower in-hospital mortality, than those with mechanical complications. Overall in-hospital survival correlates with the extent of coronary artery obstructions, location of culprit lesion and baseline coronary TIMI flow grade. (C) 2000 by the American College of Cardiology.

UR - http://www.scopus.com/inward/record.url?scp=0033863246&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0033863246&partnerID=8YFLogxK

U2 - 10.1016/S0735-1097(00)00873-1

DO - 10.1016/S0735-1097(00)00873-1

M3 - Article

C2 - 10985708

AN - SCOPUS:0033863246

VL - 36

SP - 1077

EP - 1083

JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

SN - 0735-1097

IS - 3 SUPPL. A

ER -