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Primary versus facilitated percutaneous coronary intervention in acute myocardial infarction complicated by cardiogenic shock
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Abstract
Methods: Among 98 consecutive patients with acute MI complicated by CS, 93 patients were treated with PCI and 5 patients underwent CABG. Patients treated with PCI were divided into two groups: group I included 59 patients treated with facilitated PCI and group II included 34 patients treated with primary PCI. Patients in group II were older, had higher systolic and diastolic blood pressure, and more often presented with 1-vessel disease and previous MI, while 3-vessel disease was more common in group I (all p < 0.05).
Results: Immediate PCI success rate was similar in both groups (83% in group I vs. 74% in group II, p = NS), as was in-hospital mortality (41% vs. 36%, respectively, p = NS) and mortality rate in the cardiac cathetherization laboratory (20% vs. 15%, respectively, p = NS). The need for repeated PCI was significantly more common in group I (22% vs. 3%, p = 0.02). The two groups did not differ with respect to the need for CABG or the rate of hemorrhagic complications. During one year follow-up, three deaths occurred in every group, including two patients in each group who died suddenly.
Conclusions: Comparable immediate PCI success rate, in-hospital mortality, and long-term mortality were seen in patients with acute MI complicated by CS treated with primary or facilitated PCI. More coronary reinterventions were needed in patients treated with facilitated PCI compared to those treated with primary PCI.
Abstract
Methods: Among 98 consecutive patients with acute MI complicated by CS, 93 patients were treated with PCI and 5 patients underwent CABG. Patients treated with PCI were divided into two groups: group I included 59 patients treated with facilitated PCI and group II included 34 patients treated with primary PCI. Patients in group II were older, had higher systolic and diastolic blood pressure, and more often presented with 1-vessel disease and previous MI, while 3-vessel disease was more common in group I (all p < 0.05).
Results: Immediate PCI success rate was similar in both groups (83% in group I vs. 74% in group II, p = NS), as was in-hospital mortality (41% vs. 36%, respectively, p = NS) and mortality rate in the cardiac cathetherization laboratory (20% vs. 15%, respectively, p = NS). The need for repeated PCI was significantly more common in group I (22% vs. 3%, p = 0.02). The two groups did not differ with respect to the need for CABG or the rate of hemorrhagic complications. During one year follow-up, three deaths occurred in every group, including two patients in each group who died suddenly.
Conclusions: Comparable immediate PCI success rate, in-hospital mortality, and long-term mortality were seen in patients with acute MI complicated by CS treated with primary or facilitated PCI. More coronary reinterventions were needed in patients treated with facilitated PCI compared to those treated with primary PCI.
Keywords
acute myocardial infarction; cardiogenic shock; primary percutaneous coronary intervention; facilitated percutaneous coronary intervention
About this articleTitle
Primary versus facilitated percutaneous coronary intervention in acute myocardial infarction complicated by cardiogenic shock
Journal
Issue
Vol 13, No 5 (2006): Folia Cardiologica
Pages
384-389
Published online
2006-05-25
Page views
460
Article views/downloads
815
Bibliographic record
Folia Cardiol 2006;13(5):384-389.
Keywords
acute myocardial infarction
cardiogenic shock
primary percutaneous coronary intervention
facilitated percutaneous coronary intervention
Authors
Piotr Chodór
Hubert Krupa
Tomasz Wąs
Teresa Zielińska
Radosław Lenarczyk
Mariusz Gąsior
Lech Poloński
Marian Zembala
Zbigniew Kalarus
