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Influence of circulatory support devices on morbidity and mortality of cardiogenic shock after acute myocardial infarction.

Session Poster Session 3

Speaker Ricardo Mourilhe Rocha

Congress : Heart Failure 2019

  • Topic : heart failure
  • Sub-topic : Acute Heart Failure: Non-pharmacological Treatment
  • Session type : Poster Session
  • FP Number : P1747

Authors : R Mourilhe Rocha (Rio de Janeiro,BR), GV Santos (Rio de Janeiro,BR), DXB Setta (Rio de Janeiro,BR), JP Mourilhe-Rocha (Rio de Janeiro,BR), MI Bittencourt (Rio de Janeiro,BR), RS Schneider (Rio de Janeiro,BR), MLS Bandeira (Rio de Janeiro,BR), OE Farias (Rio de Janeiro,BR), TF Carvalho (Rio de Janeiro,BR), RM Carneiro (Rio de Janeiro,BR), CL Weksler (Rio de Janeiro,BR), FOD Rangel (Rio de Janeiro,BR), R Esporcatte (Rio de Janeiro,BR)

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Authors:
R Mourilhe Rocha1 , GV Santos1 , DXB Setta1 , JP Mourilhe-Rocha1 , MI Bittencourt1 , RS Schneider1 , MLS Bandeira1 , OE Farias1 , TF Carvalho1 , RM Carneiro1 , CL Weksler1 , FOD Rangel1 , R Esporcatte1 , 1Hospital Pro Cardiaco - Rio de Janeiro - Brazil ,

Citation:

Introduction: cardiogenic shock is a state of low cardiac output that results in life risk due to organic hypoperfusion and hypoxia, and acute myocardial infarction (AMI) with left ventricular dysfunction continues to be its most frequent cause. Advances in reperfusion therapy have been associated with survival improvement, but significant regional disparities in care are reported and in-hospital mortality remains very high.

Objectives: to define the risk factors, epidemiological data and outcomes of patients admitted due to AMI who presented cardiogenic shock at admission or during admission to a tertiary hospital.

Methods: a longitudinal, observational study of consecutive patients admitted with acute coronary syndrome (ACS) from June 1, 2015 to October 31, 2017. Data were obtained from the medical records, as well as interviews of patients during hospitalization. We compared the demographic, clinical and outcomes data of patients with cardiogenic shock (wCC) and without cardiogenic shock (woCC) in this population.

Results: there were 216 patients analyzed and the incidence of cardiogenic shock was 9.7% and was manifested at admission in 33.3% of the cases. The characteristics in the wCC group and woCC were, respectively: mean age of 76.1±10.56 x 70.8±11.39 years (p=0.04), male (66.7% x 70.3%, p=0.75), smoking (28.6% x 52.3%, p=0.03), dyslipidemia (57.1% x 55.9%, p = 0.91), systemic arterial hypertension (66.7% x 77.9%, p=0.24) and diabetes mellitus (42.9% x 33.3%, p=0.38); ST elevation AMI (47.6% x 28.7%, p=0.07) and non-ST elevation AMI (52.4% x 71.3%, p=0.07). Other complications were renal dysfunction (14.3% x 7.7%, p=0.29), atrial fibrillation (19% x 7.2%, p=0.06), pericardial effusion (95.2% x 32.8%, p<0.001), cardiorespiratory arrest during hospitalization (42.9% x 1%, p<0.001), use of mechanical circulatory support device (57.1% x 1%, p <0.001). In the wCC group: intra-aortic balloon (58.3%), Centrimag (9.5%), extracorporeal membrane circulation (14.2%); and in woCC group: intra-aortic balloon (1%). Overall mortality were 61% in wCC group and 1% in woCC group (p<0.001).

Conclusion: cardiogenic shock occurred in older patients, that presented with more renal dysfunction, atrial fibrillation, pericardial effusion and cardiorespiratory arrest. Despite the technological advances in the treatment of AMI, the circulatory support devices did not reduce the morbidity and mortality of this entity, remaining extremely high.

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