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Titolo:
Management and outcome of cardiogenic shock complicating acute myocardial infarction in hospitals with and without on-site catheterisation facilities
Autore:
Barbash, IM; Behar, S; Battler, A; Hasdai, D; Boyko, V; Gottlieb, S; Leor, J;
Indirizzi:
Ben Gurion Univ Negev, Fac Hlth Sci, Soroka Med Ctr, Dept Cardiol, IL-84105 Beer Sheva, Israel Ben Gurion Univ Negev Beer Sheva Israel IL-84105 4105 Beer Sheva, Israel Chaim Sheba Med Ctr, Neufeld Cardiac Res Inst, IL-52621 Tel Hashomer, Israel Chaim Sheba Med Ctr Tel Hashomer Israel IL-52621 21 Tel Hashomer, Israel Rabin Med Ctr, Dept Cardiol, Petah Tiqwa, Israel Rabin Med Ctr Petah Tiqwa Israel Ctr, Dept Cardiol, Petah Tiqwa, Israel
Titolo Testata:
HEART
fascicolo: 2, volume: 86, anno: 2001,
pagine: 145 - 149
SICI:
1355-6037(200108)86:2<145:MAOOCS>2.0.ZU;2-B
Fonte:
ISI
Lingua:
ENG
Soggetto:
EARLY REVASCULARIZATION; CORONARY ANGIOPLASTY; MORTALITY; TRIAL;
Keywords:
percutaneous transluminal coronary angioplasty; heart failure; myocardial infarction; cardiogenic shock;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
10
Recensione:
Indirizzi per estratti:
Indirizzo: Leor, J Ben Gurion Univ Negev, Fac Hlth Sci, Soroka Med Ctr, Dept Cardiol,IL-84105 Beer Sheva, Israel Ben Gurion Univ Negev Beer Sheva Israel IL-84105 r Sheva, Israel
Citazione:
I.M. Barbash et al., "Management and outcome of cardiogenic shock complicating acute myocardial infarction in hospitals with and without on-site catheterisation facilities", HEART, 86(2), 2001, pp. 145-149

Abstract

Objective-To determine whether the availability of on-site catheterisationand revascularisation facilities influenced hospital management and outcome of patients with acute myocardial infarction complicated by cardiogenic shock. Methods-Patients with acute myocardial infarction were enrolled prospectively in four nationwide surveys during 1992,1994,1996, and 1998. The characteristics, management, and outcome of patients with cardiogenic shock were compared between hospitals with on-site catheterisation facilities (group 1;18 hospitals) and without such facilities (group 2; 8 hospitals). Results-Of 5351 patients with acute myocardial infarction, 254 (4.7%) developed cardiogenic shock. Group 1 patients (n = 186 of 3854; 4.6%) were younger (mean (SD) age, 69.6 (12) v 73.7 (10) years, p = 0.006) and had a lowerproportion of women (36% v 52%, p = 0.03) than group 2 (n = 68 of 1243; 5.2%). There was no difference in other characteristics including the use of thrombolysis. Group 1 patients more often underwent coronary angiography (26% v 4%, p < 0.001), angioplasty (21% v 4%, p = 0.002), and intra-aortic balloon counterpulsation (28% v 4%, p < 0.001). Seven day mortality was loweramong group 1 than among group 2 patients (61% v 77%, p = 0.02), even after age and sex adjustment (odds ratio (OR) 0.54; 95% confidence interval (CI) 0.28 to 1.02). This outcome benefit persisted at 30 days (74% v 88%, p = 0.01; OR 0.45,95% CI 0.18 to 0.98), and at 6 months (80% v 90%, p = 0.06; OR 0.57,95% CI 0.22 to 1.33). Conclusions-The greater use of invasive and interventional procedures in hospitals with catheterisation facilities is associated with improved survival of patients with acute myocardial infarction complicated by cardiogenic shock. Immediate availability of invasive care facilities will improve the outcome of cardiogenic shock in the community setting.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 21/10/20 alle ore 10:25:48