Outcomes Associated with Respiratory Failure for Patients with Cardiogenic Shock and Acute Myocardial Infarction: A Substudy of the CULPRIT-SHOCK Trial.

Rubini Giménez, Maria; Miller, P Elliott; Alviar, Carlos L; van Diepen, Sean; Granger, Christopher B; Montalescot, Gilles; Windecker, Stephan; Maier, Lars; Serpytis, Pranas; Serpytis, Rokas; Oldroyd, Keith G; Noc, Marko; Fuernau, Georg; Huber, Kurt; Sandri, Marcus; de Waha-Thiele, Suzanne; Schneider, Steffen; Ouarrak, Taoufik; Zeymer, Uwe; Desch, Steffen; ... (2020). Outcomes Associated with Respiratory Failure for Patients with Cardiogenic Shock and Acute Myocardial Infarction: A Substudy of the CULPRIT-SHOCK Trial. Journal of clinical medicine, 9(3) MDPI 10.3390/jcm9030860

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BACKGROUND

Little is known about clinical outcomes of patients with acute myocardial infraction (AMI) complicated by cardiogenic shock (CS) requiring mechanical ventilation (MV). The aim of this study was to identify the characteristics, risk factors, and outcomes associated with the provision of MV in this specific high-risk population.

METHODS

Patients with CS complicating AMI and multivessel coronary artery disease from the CULPRIT-SHOCK trial were included. We explored 30 days of clinical outcomes in patients not requiring MV, those with MV on admission, and those in whom MV was initiated within the first day after admission.

RESULTS

Among 683 randomized patients included in the analysis, 17.4% received no MV, 59.7% were ventilated at admission and 22.8% received MV within or after the first day after admission. Patients requiring MV had a different risk-profile. Factors independently associated with the provision of MV on admission included higher body weight, resuscitation within 24 h before admission, elevated heart rate and evidence of triple vessel disease.

CONCLUSIONS

Requiring MV in patients with CS complicating AMI is common and independently associated with mortality after adjusting for covariates. Patients with delayed MV initiation appear to be at higher risk of adverse outcomes. Further research is necessary to identify the optimal timing of MV in this high-risk population.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Windecker, Stephan

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2077-0383

Publisher:

MDPI

Language:

English

Submitter:

Nadia Biscozzo

Date Deposited:

04 Dec 2020 05:27

Last Modified:

04 Dec 2020 05:27

Publisher DOI:

10.3390/jcm9030860

PubMed ID:

32245139

Uncontrolled Keywords:

cardiogenic shock mechanical ventilation non-invasive ventilation respiratory failure

BORIS DOI:

10.7892/boris.147514

URI:

https://boris.unibe.ch/id/eprint/147514

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