CLINICAL OUTCOMES OF PATIENTS WITH CARDIOGENIC SHOCK COMPLICATING ACUTE MYOCARDIAL INFARCTION: THE GULF-CARDIOGENIC SHOCK REGISTRY
Authors: Daoulah Amin , Alshehri Mohammed , Panduranga Prashanth , Aloui Hatem M. , Yousif Nooraldaem , Arabi Abdulrahman , Almahmeed Wael , Qutub Mohammed A. , Elmahrouk Ahmed , Arafat Amr A. , Kanbr Omar , Fathey Hussien Adnan , Abdulhadi Aldossari Mubarak , Al Mefarrej Abdulmohsen H. , Shahzad Chachar Tarique , Amin Haitham , Livingston Gladsy Selva , Mohamed Al Rawahi Abeer Said , Alswuaidi Jassim , Hashmani Shahrukh , Al Jarallah Mohammed , Ghani Mohamed Ajaz , Alzahrani Badr , Jameel Naser Maryam , Qenawi Wael , Hassan Taher , Alenezi Abdullah , Hersi Ahmad S. , Alharbi Waleed , Al Obaikan Sultan , Saad Almalki Salman , Mohammed Ballool Sulafa Almukhtar , Noor Husam A. , Khalid AlSuwaidi Manar , Antony Harvey , Albasiouny Alkholy Marwa Abd Elghany , Alkhodari Khaled , Khan Hassan , Alshehri Ali , Ghonim Ahmed A. , Abualnaja Seraj , Abdirahman Kahin Mokhtar , Rajan Rajesh , Almerri Khaled , Al Nasser Faisal Omar M. , Alhaydhal Ahmed , Ashour Mohammed Awad , Elamin Omer A. , Jamjoom Ahmed , Wedinly Sary Mahmoud , Elmahrouk Youssef , Dahdouh Ziad , Ross Ethan M. , Al Maashani Said , Abohasan Abdulwali , Tawfik Wael , Balghith Mohammed , Elganady Abdelmaksoud , Abdulhabeeb Ibrahim A M , Borini Rasha Mohammed , Basardah Ayman , Alqahtani Abdulrahman M. , Aldossari Alaa , Alsuayri Abdullah Omair , Khan Mushira , Lotfi Amir 
Published: August 2024

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.