Abstract 156: Initial Characteristics and Outcomes of Cardiogenic Shock Due to Acute Heart Failure in Comparison with Acute Myocardial Infarction
Background: Recently, the mortality of patients with cardiogenic shock (CS) secondary to acute myocardial infarction (AMI) has been improved by reperfusion therapy and mechanical circulatory support. Acute heart failure (AHF) is frequently encountered in cardiovascular emergency setting as AMI. However, the initial characteristics and outcomes of patients with CS secondary to AHF has not yet been clarified.
Methods: Data from the Tokyo CCU Network registry cohort from 2010 to 2011 were analyzed. Study 1; we made a comparison of the clinical data between CS patients with AHF (group HF) and those with AMI (group MI). Study 2; we analyzed critical factors determining the prognosis of the group HF.
Results: Among a total of 19316 registered patients, 6247 were AHF and 5535 were AMI. Patients with cardiac arrest were excluded from this analysis. Therefore, we analyzed 143 patients of group HF and 307 patients of group MI. Study 1; underlying cardiac disease of group HF consisted of ischemic heart disease (23%), cardiomyopathy (21%), valvular heart disease (23%), hypertensive heart disease (7%) and so on. The mortality rates were not different between underlying cardiac disease (cardiomyopathy 42.9%, valvular heart disease 36.7% and ischemic heart disease 26.7%). In comparison between the 2 groups, the group HF was less male (51% vs 71%, p<0.001) and lower body mass index (20.8±4.0 vs 23.0±3.8, p<0.001). The time from EMS arrival to ER arrival was not different between the 2 groups. In-hospital mortality of the group HF was higher than that of the group MI (28.7% vs 16.0%, p=0.037). Study 2; in the group HF, there are no significant differences between survivor and non-survivor in term of respiratory rate, systolic blood pressure and pulse rate both at EMS arrival and at ER arrival. However, delta oxygen saturation ([[Unable to Display Character: ⊿]]SpO2=SpO2 at ER arrival-SpO2 at EMS arrival) was higher in survivor (+4.8% vs +0.0%, p=0.021).
Conclusion: The initial characteristics and outcomes of CS patients due to AHF was clarified. Early and appropriate management including prehospital care would be important for CS due to AHF as well as for due to AMI.
Author Disclosures: Y. Hosokawa: None. T. Yamamoto: None. K. Nagao: None. E. Tachibana: None. T. Takayama: None. W. Shimizu: None. M. Takayama: None.
- © 2014 by American Heart Association, Inc.