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. 2024 Aug 1;25(8):274.
doi: 10.31083/j.rcm2508274. eCollection 2024 Aug.

The Association between Cardiac Arrest and Mortality in Patients with Acute Myocardial Infarction Complicated by Cardiogenic Shock

Qian-Feng Xiao  1 , Xin Wei  1 , Si Wang  1 , Ying Xu  1 , Yan Yang  1 , Fang-Yang Huang  1 , Mao Chen  1
Affiliations

The Association between Cardiac Arrest and Mortality in Patients with Acute Myocardial Infarction Complicated by Cardiogenic Shock

Qian-Feng Xiao et al. Rev Cardiovasc Med. .

Abstract

Background: The impact of cardiac arrest (CA) at admission on the prognosis of patients with acute myocardial infarction (AMI) complicated by cardiogenic shock (CS) remains a subject of debate.

Methods: We conducted a retrospective study at West China Hospital from 2018 to 2021, enrolling 247 patients with AMI complicated by CS (AMI-CS). Patients were categorized into CA and non-CA groups based on their admission status. Univariate and multivariate Cox regression analyses were performed, with 30-day and 1-year mortality as the primary endpoints. Kaplan-Meier plots were constructed, and concordance (C)-indices of the Global Registry of Acute Coronary Event (GRACE) score, Intra-aortic Balloon Pump in Cardiogenic Shock (IABP-SHOCK) II score, and IABP-SHOCK II score with CA were calculated.

Results: Among the enrolled patients, 39 experienced CA and received cardiopulmonary resuscitation at admission. The 30-day and 1-year mortality rates were 40.9% and 47.0%, respectively. Neither univariate nor multivariate Cox regression analyses identified CA as a significant risk factor for 30-day and 1-year mortality. In C-statistics, the GRACE score exhibited a moderate effect (C-indices were 0.69 and 0.67, respectively), while the IABP-SHOCK II score had a better predictive performance (C-indices were 0.79 and 0.76, respectively) for the 30-day and 1-year mortality. Furthermore, CA did not enhance the predictive value of the IABP-SHOCK II score for 30-day (p = 0.864) and 1-year mortality (p = 0.888).

Conclusions: Cardiac arrest at admission did not influence the survival of patients with AMI-CS. Active resuscitation should be prioritized for patients with AMI-CS, regardless of the presence of cardiac arrest.

Keywords: acute myocardial infarction; cardiac arrest; cardiogenic shock; mortality.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1.
Fig. 1.
Kaplan–Meier plot of 30-day and 1-year mortality in AMI-related CS patients with and without CA. Abbreviations: AMI, acute myocardial infarction; CS, cardiogenic shock; CA, cardiac arrest.
See this image and copyright information in PMC

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