Article
作者: Qenawi, Wael ; Arabi, Abdulrahman ; Alharbi, Waleed ; Kanbr, Omar ; Daoulah, Amin ; Alshehri, Ali ; Ghonim, Ahmed A. ; Elganady, Abdelmaksoud ; Aldossari, Alaa ; Noor, Husam A. ; Panduranga, Prashanth ; Jameel Naser, Maryam ; Basardah, Ayman ; Elamin, Omer A. ; Livingston, Gladsy Selva ; Saad Almalki, Salman ; Elmahrouk, Ahmed ; Khan, Hassan ; Yousif, Nooraldaem ; Balghith, Mohammed ; Antony, Harvey ; Fathey Hussien, Adnan ; Amin, Haitham ; Al Jarallah, Mohammed ; Borini, Rasha Mohammed ; Al Obaikan, Sultan ; Abohasan, Abdulwali ; Alhaydhal, Ahmed ; Almahmeed, Wael ; Alqahtani, Abdulrahman M. ; Ashour, Mohammed Awad ; Hashmani, Shahrukh ; Alenezi, Abdullah ; Abualnaja, Seraj ; Khan, Mushira ; Abdirahman Kahin, Mokhtar ; Alzahrani, Badr ; Aloui, Hatem M. ; Wedinly, Sary Mahmoud ; Elmahrouk, Youssef ; Jamjoom, Ahmed ; Shahzad Chachar, Tarique ; Al Nasser, Faisal Omar M. ; Alsuayri, Abdullah Omair ; Almerri, Khaled ; Hassan, Taher ; Ross, Ethan M. ; Abdulhabeeb, Ibrahim A M ; Al Mefarrej, Abdulmohsen H. ; Ghani, Mohamed Ajaz ; Abdulhadi Aldossari, Mubarak ; Al Maashani, Said ; Alkhodari, Khaled ; Arafat, Amr A ; Lotfi, Amir ; Alswuaidi, Jassim ; Tawfik, Wael ; Rajan, Rajesh ; Dahdouh, Ziad ; Qutub, Mohammed A. ; Arafat, Amr A. ; Hersi, Ahmad S. ; Albasiouny Alkholy, Marwa Abd Elghany ; Mohamed Al Rawahi, Abeer Said ; Khalid AlSuwaidi, Manar ; Alshehri, Mohammed ; Mohammed Ballool, Sulafa Almukhtar
ABSTRACT:Background: There is a paucity of data regarding acute myocardial infarction (MI) complicated by cardiogenic shock (AMI-CS) in the Gulf region. This study addressed this knowledge gap by examining patients experiencing AMI-CS in the Gulf region and analyzing hospital and short-term follow-up mortality. Methods: The Gulf-Cardiogenic Shock registry included 1,513 patients with AMI-CS diagnosed between January 2020 and December 2022. Results: The incidence of AMI-CS was 4.1% (1,513/37,379). The median age was 60 years. The most common presentation was ST-elevation MI (73.83%). In-hospital mortality was 45.5%. Majority of patients were in SCAI (Society for Cardiovascular Angiography and Interventions shock classification) stage D and E (68.94%). Factors associated with hospital mortality were previous coronary artery bypass graft (odds ratio [OR]: 2.49; 95% confidence interval [CI]: 1.321–4.693), cerebrovascular accident (OR: 1.621; 95% CI: 1.032–2.547), chronic kidney disease (OR: 1.572; 95% CI: 1.158–2.136), non-ST-elevation MI (OR: 1.744; 95% CI: 1.058–2.873), cardiac arrest (OR: 5.702; 95% CI: 3.640–8.933), SCAI stage D and E (OR: 19.146; 95% CI: 9.902–37.017), prolonged QRS (OR: 10.012; 95% CI: 1.006–1.019), right ventricular dysfunction (OR: 1.679; 95% CI: 1.267–2.226), and ventricular septal rupture (OR: 6.008; 95% CI: 2.256–15.998). Forty percent had invasive hemodynamic monitoring, 90.02% underwent revascularization, and 45.80% received mechanical circulatory support (41.31% had intra-aortic balloon pump and 14.21% had extracorporeal membrane oxygenation/Impella devices). Survival at 12 months was 51.49% (95% CI: 46.44%–56.29%). Conclusions: The study highlighted the significant burden of AMI-CS in this region, with high in-hospital mortality. The study identified several key risk factors associated with increased hospital mortality. Despite the utilization of invasive hemodynamic monitoring, revascularization, and mechanical circulatory support in a substantial proportion of patients, the 12-month survival rate remained relatively low.