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. 2025 Jan 8;77(1):7.
doi: 10.1186/s43044-024-00599-8.

Biventricular dysfunction predicts mortality in ST elevation myocardial infarction patients with cardiogenic shock

Angga Dwi Prasetyo  1 , Hendry Purnasidha Bagaswoto  2 , Firandi Saputra  1 , Erika Maharani  1 , Budi Yuli Setianto  1
Affiliations

Biventricular dysfunction predicts mortality in ST elevation myocardial infarction patients with cardiogenic shock

Angga Dwi Prasetyo et al. Egypt Heart J. .

Abstract

Background: The incidence of mortality in patients with cardiogenic shock due to ST elevation myocardial infarction (STEMI) remains high even with prompt reperfusion therapy. Ventricular systolic dysfunction is the primary condition causing cardiogenic shock in STEMI. Studies have been widely conducted on the left ventricle (LV) and right ventricle (RV) systolic dysfunction related to mortality events. However, the parameters of biventricular systolic dysfunction predicting mortality as a stronger predictor of mortality are still unclear. Accordingly, we evaluated the predictor mortality value of biventricular systolic dysfunction in STEMI patients with cardiogenic shocks. Based on The Society for Cardiovascular Angiography and Intervention classification, we analyzed data from November 2021 to September 2023 at Dr. Sardjito General Hospital in Yogyakarta, Indonesia, using the Sardjito Cardiovascular Intensive Care (SCIENCE) registry with a retrospective cohort design. Multivariate logistic regression analysis was used to assess predictors of in-hospital mortality.

Results: There were 1,059 subjects with a mean ± SD age of 59 ± 11 years, dominated by men (80.5%) who met the inclusion and exclusion criteria. Based on multivariate analysis, biventricular dysfunction (BVD) is a factor that significantly increases the risk of in-hospital mortality (Odds ratio [OR], 1.771: 95% confidence interval [CI] 1.113-2.819; p = 0.016). Other significant factors affecting mortality were renal failure (OR, 5.122; 95% CI 3.233-8.116; p < 0.001), percutaneous coronary intervention (PCI) (OR, 0.493; 95% CI 0.248-0.981; p = 0.044), and inotropic/vasopressor (OR, 6.876; 95% CI 4.583-10.315; p < 0.001).

Conclusions: Biventricular dysfunction significantly increases the risk of in-hospital mortality in STEMI patients with cardiogenic shock. Renal failure, PCI, and the requirement for inotropic or vasopressor drugs are also factors that influence in-hospital mortality.

Keywords: Cardiogenic shock; Echocardiography; Mortality; ST elevated myocardial infarction.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study has been approved by the Medical and Health Research Ethics Committee of the Faculty of Medicine, Nursing and Public Health, Universitas Gadjah Mada, Yogyakarta, Indonesia, with number KE/FK/1707/EC/2023, and was conducted according to the ethical guidelines of the 2013 Declaration of Helsinki. The Institutional Medical Ethics Committee waived the requirement for informed consent for retrospectively enrolled patients. Consent for publication: Not applicable. Competing interests: The authors declare they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram showing study inclusion and exclusion criteria. Patients with STEMI from November 2021 to September 2023 were included. The total number of eligible subjects in this study were 1059. STEMI ST elevation myocardial infarction; SCIENCE Sardjito Cardiovascular Intensive Care
Fig. 2
Fig. 2
Three-dimensional bar graph showing hospital mortality, ventricular systolic dysfunction, and SCAI shock stage. LV left ventricular; RV right ventricular; SCAI Society for Cardiovascular Angiography and Interventions. Because of the low number of patients in SCAI shock stage E, we grouped SCAI shock stages D and E for analysis
See this image and copyright information in PMC

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