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. 2024 Oct 1;62(4):512-521.
doi: 10.1097/SHK.0000000000002433. Epub 2024 Aug 12.

CLINICAL OUTCOMES OF PATIENTS WITH CARDIOGENIC SHOCK COMPLICATING ACUTE MYOCARDIAL INFARCTION: THE GULF-CARDIOGENIC SHOCK REGISTRY

Amin Daoulah  1 , Mohammed Alshehri  2 , Prashanth Panduranga  3 , Hatem M Aloui  4 , Nooraldaem Yousif  5 , Abdulrahman Arabi  6 , Wael Almahmeed  7 , Mohammed A Qutub  8 , Ahmed Elmahrouk, Amr A Arafat, Omar Kanbr  9 , Adnan Fathey Hussien  10 , Mubarak Abdulhadi Aldossari  4 , Abdulmohsen H Al Mefarrej  4 , Tarique Shahzad Chachar  5 , Haitham Amin  5 , Gladsy Selva Livingston  3 , Abeer Said Mohamed Al Rawahi  3 , Jassim Alswuaidi  6 , Shahrukh Hashmani  7 , Mohammed Al Jarallah  11 , Mohamed Ajaz Ghani  12 , Badr Alzahrani  13 , Maryam Jameel Naser  14 , Wael Qenawi  2 , Taher Hassan  15 , Abdullah Alenezi  16 , Ahmad S Hersi  17 , Waleed Alharbi  17 , Sultan Al Obaikan  18 , Salman Saad Almalki  4 , Sulafa Almukhtar Mohammed Ballool  4 , Husam A Noor  5 , Manar Khalid AlSuwaidi  5 , Harvey Antony  3 , Marwa Abd Elghany Albasiouny Alkholy  3 , Khaled Alkhodari  6 , Hassan Khan  7 , Ali Alshehri  19 , Ahmed A Ghonim  8 , Seraj Abualnaja  20 , Mokhtar Abdirahman Kahin  10 , Rajesh Rajan  11 , Khaled Almerri  16 , Faisal Omar M Al Nasser  12 , Ahmed Alhaydhal  13 , Mohammed Awad Ashour  6 , Omer A Elamin  1 , Ahmed Jamjoom  1 , Sary Mahmoud Wedinly  8 , Youssef Elmahrouk  21 , Ziad Dahdouh  22 , Ethan M Ross  23 , Said Al Maashani  24 , Abdulwali Abohasan  25 , Wael Tawfik, Mohammed Balghith  26 , Abdelmaksoud Elganady, Ibrahim A M Abdulhabeeb  27 , Rasha Mohammed Borini  16 , Ayman Basardah  17 , Abdulrahman M Alqahtani  28 , Alaa Aldossari  28 , Abdullah Omair Alsuayri  29 , Mushira Khan  30 , Amir Lotfi  31
Affiliations

CLINICAL OUTCOMES OF PATIENTS WITH CARDIOGENIC SHOCK COMPLICATING ACUTE MYOCARDIAL INFARCTION: THE GULF-CARDIOGENIC SHOCK REGISTRY

Amin Daoulah et al. Shock. .

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-Cardiogenic Shock registry included 1,513 patients with AMI-CS diagnosed between January 2020 and December 2022. Results: The incidence of AMI-CS was 4.1% (1,513/37,379). 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 (Society for Cardiovascular Angiography and Interventions shock classification) stage D and E (68.94%). Factors associated with hospital mortality were previous coronary artery bypass graft (odds ratio [OR]: 2.49; 95% confidence interval [CI]: 1.321-4.693), cerebrovascular accident (OR: 1.621; 95% CI: 1.032-2.547), chronic kidney disease (OR: 1.572; 95% CI: 1.158-2.136), 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; 95% CI: 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.

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Conflict of interest statement

The authors report no conflicts of interest.

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