1. Plasma glucose and not hemoglobin or renal function predicts mortality in patients with STEMI complicated with cardiogenic shock.
- Author
-
Vis MM, Engström AE, Sjauw KD, Tjong FV, Baan J Jr, Koch KT, DeVries JH, Tijssen JG, de Winter RJ, Piek JJ, and Henriques JP
- Subjects
- Aged, Anemia blood, Anemia complications, Angioplasty, Balloon, Coronary mortality, Biomarkers blood, Chi-Square Distribution, Female, Humans, Hyperglycemia blood, Hyperglycemia complications, Kidney metabolism, Logistic Models, Male, Middle Aged, Myocardial Infarction blood, Myocardial Infarction complications, Myocardial Infarction physiopathology, Myocardial Infarction therapy, Netherlands, Odds Ratio, Patient Admission, Prospective Studies, Registries, Risk Assessment, Risk Factors, Shock, Cardiogenic blood, Shock, Cardiogenic etiology, Shock, Cardiogenic physiopathology, Time Factors, Treatment Outcome, Anemia mortality, Blood Glucose metabolism, Creatinine blood, Hemoglobins metabolism, Hyperglycemia mortality, Kidney physiopathology, Myocardial Infarction mortality, Shock, Cardiogenic mortality
- Abstract
Objective: To assess the predictive value of three biomarkers for mortality in ST-segment elevation myocardial infarction (STEMI) with cardiogenic shock., Background: STEMI complicated by cardiogenic shock accounts for the majority of STEMI related deaths. Patients with STEMI and hyperglycemia, anemia or kidney dysfunction on admission have a poor prognosis. As data on the combination of those three established predictors of mortality are sparse in STEMI with cardiogenic shock, the objective of the current study was to investigate their predictive value in STEMI patients with cardiogenic shock., Methods and Results: Between 1997 and 2005, a total of 3038 patients presented with STEMI and were treated with percutaneous coronary intervention (PCI). On admission 292 patients presented with cardiogenic shock. Glucose, hemoglobin and creatinine clearance were available in 183 out of 292 patients. Overall 1-year mortality was 34%. In multivariate logistic regression analysis, only glucose remained a strong independent predictor for mortality. The odds for mortality increased by 11% for each 1 mmol/l increase in glucose (OR 1.11, 95% CI 1.02-1.21, P = 0.013)., Conclusion: Hemoglobin and creatinine clearance bear no prognostic value. Only admission glucose levels strongly and independently predict 1-year mortality in STEMI patients with cardiogenic shock and treated with PCI.
- Published
- 2010
- Full Text
- View/download PDF