Electrocardiographic patterns and clinical outcomes of acute coronary syndrome cardiogenic shock in patients undergoing percutaneous coronary intervention - A propensity score analysis.

OBJECTIVES

To determine the influence of presenting electrocardiographic (ECG) changes on prognosis in acute coronary syndrome cardiogenic shock (ACS-CS) patients undergoing percutaneous coronary angiography (PCI).

BACKGROUND

The effect of initial ECG changes such as ST-elevation myocardial infarction (STEMI) versus non-STEMI among patients ACS-CS on prognosis remains unclear.

METHODS

We analysed data from consecutive patients with ACS-CS enrolled in the Victorian Cardiac Outcomes registry between 2014 and 2020. Inverse probability of treatment weighting analysis (IPTW) was used to assess the effect of ECG changes on 30-day mortality.

RESULTS

Of 1564 patients with ACS-CS who underwent PCI, 161 had non-STEMI and 1403 had STEMI on ECG. The mean age was 66 ± 13 years, and 74 % (1152) were males. Patients with non-STEMI compared to STEMI were older (70 ± 12 vs 65 ± 13 years), had higher rates of diabetes (34 % vs 21 %), prior coronary artery bypass graft surgery (14 % vs 3.3 %), peripheral arterial disease (10.6 % vs 4.1 %, p < 0.01), and lower baseline eGFR (53.8 [37.1, 75.4] vs 65.3 [46.3, 87.8] ml/min/1.73m

CONCLUSIONS

In patients undergoing PCI, Non-STEMI as compared to STEMI on index ECG was associated with approximately half the relative risk of both 30-day mortality and 30-day MACCE and could be a useful variable to integrate in ACS-CS risk scores.

Informations de copyright

Copyright © 2024. Published by Elsevier Inc.

Déclaration de conflit d'intérêts

Declaration of competing interest Dr. N D’Elia – None; [e-mail] Ms Sara Vogrin – None; [e-mail] Ms Angela Brennan – None; [e-mail] Ms Diem Dinh – None; [e-mail] Dr. Jeffrey Lefkovits – None; [e-mail] Professor Christopher Reid – None; [e-mail] A/Prof Dion Stub - Proctor for Medtronic, Edwards and Abbott. Research supported by the National Heart Foundation and NHMRC fellowships; [e-mail] Dr. Jason Bloom – None; [e-mail] Dr. Kawa Haji – None; [e-mail] Dr. Samer Noaman – None; [e-mail] Professor David Kaye – None; [e-mail] A/Prof Nicholas Cox – None; [e-mail] A/Prof William Chan – None; [e-mail]