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001-es BibID:BIBFORM091394
035-os BibID:(cikkazonosító)969
Első szerző:Szabó Gábor Tamás (kardiológus)
Cím:Predictors of Hospital Mortality in Patients with Acute Coronary Syndrome Complicated by Cardiogenic Shock / Szabó Gábor Tamás, Ágoston András, Csató Gábor, Rácz Ildikó, Bárány Tamás, Uzonyi Gábor, Szokol Miklós, Sármán Balázs, Jebelovszki Éva, Édes István Ferenc, Czuriga Dániel, Kolozsvári Rudolf, Csanádi Zoltán, Édes István, Kőszegi Zsolt
Dátum:2021
ISSN:1424-8220
Megjegyzések:As demonstrated by earlier studies, pre-hospital triage with trans-telephonic electrocardiogram (TTECG) and direct referral for catheter therapy shows great value in the management of out-of-hospital chest pain emergencies. It does not only improve in-hospital mortality in ST-segment elevation myocardial infarction, but it has also been identified as an independent predictor of higher in-hospital survival rate. Since TTECG-facilitated triage shortens both transport time and percutaneous coronary intervention (PCI)-related procedural time intervals, it was hypothesized that even high-risk patients with acute coronary syndrome (ACS) and cardiogenic shock (CS) might also benefit from TTECG-based triage. Here, we decided to examine our database for new triage- and left ventricular (LV) function-related parameters that can influence in-hospital mortality in ACS complicated by CS. ACS patients were divided into two groups, namely, (1) hospital death patients (n = 77), and (2) hospital survivors (control, n = 210). Interestingly, TTECG-based consultation and triage of CS and ACS patients were confirmed as significant independent predictors of lower hospital mortality risk (odds ratio (OR) 0.40, confidence interval (CI) 0.21?0.76, p = 0.0049). Regarding LV function and blood chemistry, a good myocardial reperfusion after PCI (high area at risk (AAR) blush score/AAR LV segment number; OR 0.85, CI 0.78?0.98, p = 0.0178) and high glomerular filtration rate (GFR) value at the time of hospital admission (OR 0.97, CI 0.96?0.99, p = 0.0042) were the most crucial independent predictors of a decreased risk of in-hospital mortality in this model. At the same time, a prolonged time interval between symptom onset and hospital admission, successful resuscitation, and higher peak creatine kinase activity were the most important independent predictors for an increased risk of in-hospital mortality. In ACS patients with CS, (1) an early TTECG-based eleconsultation and triage, as well as (2) good myocardial perfusion after PCI and a high GFR value at the time of hospital admission, appear as major independent predictors of a lower in-hospital mortality rate.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Megjelenés:Sensors. - 21 : 3 (2021), p. 1-13. -
További szerzők:Ágoston András Csató Gábor Rácz Ildikó (1973-) (kardiológus) Bárány Tamás Uzonyi Gábor Szokol Miklós (1971-) (kardiológus) Sármán Balázs (1976-) (kardiológus) Jebelovszki Éva Édes István Ferenc (1980-) (kardiológus) Czuriga Dániel (1982-) (kardiológus) Kolozsvári Rudolf (1976-) (kardiológus) Csanádi Zoltán (1960-) (kardiológus) Édes István (1952-) (kardiológus) Kőszegi Zsolt (1962-) (kardiológus, belgyógyász)
Pályázati támogatás:GINOP-2.3.2-15-2016-00043
GINOP
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