FREQUENCY OF MORTALITY IN CARDIOGENIC SHOCK ASSOCIATED WITH ST ELEVATION MYOCARDIAL INFARCTION IN PATIENTS UNDERGOING PRIMARY PCI

Abstract

Objective: To determine the frequency of mortality in cardiogenic shock (CS) with ST elevation myocardial infarction (STEMI) in patients undergoing primary percutaneous coronary intervention (P.PCI).

Study Design: Cross sectional study.

Place and Duration of Study: Armed Forces Institute of Cardiology, CCU, Rawalpindi, from Oct 2012 to Apr 2013.

Methodology: One Hundred patients of MI with CS were included who met the inclusion criteria. Patients with structural heart defects (valvular heart disease), previous history of MI/NSTEMI, known case of DCM (dilated cardiomyopathy) and patients with previous history of cardiac intervention were excluded. ECG of all such patients was done and then was followed by P.PCI. Mortality was determined within two weeks after
undergoing primary PCI.

Results: Among 100 STEMI patients with CS who underwent primary PCI 60 patients remained alive and 40 died within two weeks of primary PCI. There were more male patients (76) with CS as compared to female patients (24). Older patients (56-65 years) had an increased tendency of suffering from CS and had a higher mortality as compared to the younger population.

Conclusion: Majority of patients with acute MI and CS undergoing primary PCI as a modality of treatment survived indicating that mortality was significantly reduced with P.PCI. Mortality was same in both males and females however it was increased in older age group (56-65 years). Therefore all patients with MI complicated with CS should undergo P.PCI. If there is delay in transfer they should be managed conservatively then transferred for PCI as it will reduce mortality.