Clinical outcomes of patients with cardiogenic shock complicating acute myocardial infarction: The Gulf-Cardiogenic Shock (G-CS) Registry

Daoulah A 1 , Alshehri M 2 , Panduranga P 3 , Aloui HM 4 , Yousif N 5 , Arabi A 6 Show all authors , Almahmeed W 7 , Qutub MA 8 , Elmahrouk A , Arafat AA , Kanbr O 9 , Hussien AF 10 , Aldossari MA 4 , Al Mefarrej AH 4 , Chachar TS 5 , Amin H 5 , Livingston GS 3 , Al Rawahi ASM 3 , Alswuaidi J 6 , Hashmani S 7 , Al Jarallah M 11 , Ghani MA 12 , Alzahrani B 13 , Naser MJ 14 , Qenawi W 2 , Hassan T 15 , Alenezi A 16 , Hersi AS 17 , Alharbi W 17 , Al Obaikan S 18 , Almalki SS 4 , Ballool SAM 4 , Noor HA 5 , AlSuwaidi MK 5 , Antony H 3 , Alkholy MAEA 3 , Alkhodari K 6 , Khan H 7 , Alshehri A 19 , Ghonim AA 8 , Abualnaja S 10 , Kahin MA 10 , Rajan R 11 , Almerri K 16 , Al Nasser FOM 12 , Alhaydhal A 13 , Ashour MA 6 , Elamin OA 1 , Jamjoom A 1 , Wedinly SM 8 , Elmahrouk Y 20 , Dahdouh Z 21 , Ross EM 22 , Al Maashani S 23 , Abohasan A 24 , Tawfik W , Balghith M 25 , Elganady A , Abdulhabeeb IAM 26 , Borini RM 16 , Basardah A 17 , Alqahtani AM 27 , Aldossari A 27 , Alsuayri AO 13 , Khan M 28 , Lotfi A 29

Affiliations 

  • 1 Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Jeddah, Kingdom of Saudi Arabia
  • 2 Department of Cardiology, Prince Khaled Bin Sultan Cardiac Center, Khamis Mushait, Kingdom of Saudi A
  • 3 Department of Cardiology, National Heart Center, Royal Hospital, Muscat, Sultanate of Oman
  • 4 Heart Health Center, King Saud Medical City, Riyadh, Kingdom of Saudi Arabia
  • 5 Department of Cardiology, Mohammed Bin Khalifa Specialist Cardiac Center, Awali, Kingdom of Bahrain
  • 6 Department of Cardiology, Hamad Medical Corporation, Doha, Qatar
  • 7 Heart & Vascular Institute, Cleveland Clinic Abu Dhabi, UAE
  • 8 Cardiology Center of Excellence, Department of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
  • 9 Faculty of Medicine, Elrazi University, Khartoum, Sudan
  • 10 Department of Cardiology, International Medical Center, Jeddah, Kingdom of Saudi Arabia
  • 11 Department of Cardiology, Sabah Al Ahmad Cardiac Center, Al Amiri Hospital, Sharq, Kuwait
  • 12 Department of Cardiology, Madinah Cardiac Center, Madinah, kingdom of Saudi Arabia
  • 13 Department of Cardiology, Prince Sultan Cardiac Center, Riyadh, Kingdom of Saudi Arabia
  • 14 Department of Medicine, Baystate Medical Center, 759 Chestnut St, Springfield, Massachusetts, USA
  • 15 Department of Cardiology, Bugshan General Hospital, Jeddah, Kingdom of Saudi Arabia
  • 16 Department of Cardiology, Chest Diseases Hospital, Sabah Medical Area, Shuwaikh, Kuwait
  • 17 Department of Cardiac Sciences, King Fahad Cardiac Center, King Saud University, Riyadh, Kingdom of Saudi Arabia
  • 18 Department of Anesthesia, King Abdulaziz medical City, National Guard Health affairs, Riyadh, Kingdom of Saudi Arabia
  • 19 Department of Cardiology, College of Medicine, King Khalid University, Abha, kingdom of Saudi Arabia
  • 20 Faculty of Medicine, Tanta University, Tanta, Egypt
  • 21 Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Riyadh, Kingdom of Saudi Arabia
  • 22 Department of Emergency Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, United States
  • 23 Department of Cardiology, Salalah Heart Center, Sultan Qaboos Hospital, Salalah, Oman
  • 24 Department of Cardiology, Central Hospital Hafr Albatin, Hafr Albatin, Kingdom of Saudi Arabia
  • 25 King Abdulaziz Cardiac Center, College of Medicine, King Saud Bin Abdulaziz University for Health Science, Riyadh, kingdom of Saudi Arabia
  • 26 Department of Cardiology, King Abdulaziz Specialist Hospital, Al Jawf, Kingdom of Saudi Arabia
  • 27 Department of Cardiology, King Salman Heart Center, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia
  • 28 College of Medicine, Al Faisal University, Riyadh, Kingdom of Saudi Arabia
  • 29 Department of Cardiovascular Medicine, University of Massachusetts Chan Medical School - Baystate Medical Center, Springfield, Massachusetts, USA 01199
Shock, 2024 Aug 12.
PMID: 39158570 DOI: 10.1097/SHK.0000000000002433

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-CS registry included 1,513 patients with AMI-CS diagnosed between January 2020 and December 2022.

RESULTS: The incidence of AMI-CS was 4.1% (1513/37379). 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 stage D and E (68.94%). Factors associated with hospital mortality were previous coronary artery bypass graft (OR:2.49; 95%CI: 1.321-4.693), cerebrovascular accident (OR:1.621, 95%CI: 1.032-2.547), chronic kidney disease (OR:1.572; 95%CI1.158-2.136), 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; 95CI%: 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.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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