Jeopardized Myocardium and Survival in Patients Presenting to the Catheterization Laboratory With ST-Elevation Myocardial Infarction and Shock

Research output: Contribution to journal › Journal article › Research › peer-review

Standard

Jeopardized Myocardium and Survival in Patients Presenting to the Catheterization Laboratory With ST-Elevation Myocardial Infarction and Shock. / Joshi, Francis R; Pedersen, Frants; Räder, Sune; Raunsø, Jakob; Kjaergaard, Jesper; Lindholm, Matias; Hassager, Christian; Engstrøm, Thomas; Holmvang, Lene; Helqvist, Steffen; Jørgensen, Erik.

In: Cardiovascular Revascularization Medicine, Vol. 21, No. 7, 07.2020, p. 843-848.

Research output: Contribution to journal › Journal article › Research › peer-review

Harvard

Joshi, FR, Pedersen, F, Räder, S, Raunsø, J, Kjaergaard, J, Lindholm, M, Hassager, C, Engstrøm, T, Holmvang, L, Helqvist, S & Jørgensen, E 2020, 'Jeopardized Myocardium and Survival in Patients Presenting to the Catheterization Laboratory With ST-Elevation Myocardial Infarction and Shock', Cardiovascular Revascularization Medicine, vol. 21, no. 7, pp. 843-848. https://doi.org/10.1016/j.carrev.2019.11.002

APA

Joshi, F. R., Pedersen, F., Räder, S., Raunsø, J., Kjaergaard, J., Lindholm, M., Hassager, C., Engstrøm, T., Holmvang, L., Helqvist, S., & Jørgensen, E. (2020). Jeopardized Myocardium and Survival in Patients Presenting to the Catheterization Laboratory With ST-Elevation Myocardial Infarction and Shock. Cardiovascular Revascularization Medicine, 21(7), 843-848. https://doi.org/10.1016/j.carrev.2019.11.002

Vancouver

Joshi FR, Pedersen F, Räder S, Raunsø J, Kjaergaard J, Lindholm M et al. Jeopardized Myocardium and Survival in Patients Presenting to the Catheterization Laboratory With ST-Elevation Myocardial Infarction and Shock. Cardiovascular Revascularization Medicine. 2020 Jul;21(7):843-848. https://doi.org/10.1016/j.carrev.2019.11.002

Author

Joshi, Francis R ; Pedersen, Frants ; Räder, Sune ; Raunsø, Jakob ; Kjaergaard, Jesper ; Lindholm, Matias ; Hassager, Christian ; Engstrøm, Thomas ; Holmvang, Lene ; Helqvist, Steffen ; Jørgensen, Erik. / Jeopardized Myocardium and Survival in Patients Presenting to the Catheterization Laboratory With ST-Elevation Myocardial Infarction and Shock. In: Cardiovascular Revascularization Medicine. 2020 ; Vol. 21, No. 7. pp. 843-848.

Bibtex

@article{80094912f6e04390b76762d33475c55c,

title = "Jeopardized Myocardium and Survival in Patients Presenting to the Catheterization Laboratory With ST-Elevation Myocardial Infarction and Shock",

abstract = "OBJECTIVE: We aimed to relate the amount of jeopardized myocardium to mortality in shocked patients presenting to the catheterization laboratory with ST-elevation myocardial infarction (STEMI) and cardiogenic shock.BACKGROUND: In contrast with historical data and previous professional guidance, contemporary randomized data suggest that multi-vessel revascularization in such patients does not improve survival; mechanistic insight is incomplete.METHODS: Clinical databases identified cases of STEMI and shock triaged for primary percutaneous coronary intervention (PPCI) in Eastern Denmark from June 2011 to December 2014 (n = 128). British Cardiovascular Intervention Society (BCIS)-1 jeopardy scores were calculated from angiography. The study endpoint was 30-day mortality.RESULTS: Median lactate values were 6.0 [2.9-10.7] mmol/L. 30-day mortality was 53.9%. 68% of patients had multi-vessel coronary disease. Median pre-PCI BCIS-1 myocardial jeopardy scores were 8 [6-10]. After multiple logistic regression increasing age (p = 0.008; odds ratio [OR] 1.06), lactate values (p = 0.017; OR 1.02), mechanical ventilation (p = 0.011; OR 1.25) and a systolic blood pressure ≤ 90 mmHg at end-case (p = 0.005; OR 1.26) were predictive of 30-day mortality. Post-PPCI culprit vessel TIMI 3 flow was associated with reduced mortality (p < 0.001; OR 0.66). There was no association between pre-PCI jeopardy scores and the primary endpoint.CONCLUSIONS: In patients with STEMI and shock, myocardial jeopardy scores do not relate to patient outcomes. Jeopardy scores may be applied to existing datasets in order to understand why multi-vessel revascularization does not lead to the anticipated clinical benefits in cardiogenic shock.",

author = "Joshi, {Francis R} and Frants Pedersen and Sune R{\"a}der and Jakob Rauns{\o} and Jesper Kjaergaard and Matias Lindholm and Christian Hassager and Thomas Engstr{\o}m and Lene Holmvang and Steffen Helqvist and Erik J{\o}rgensen",

year = "2020",

month = jul,

doi = "10.1016/j.carrev.2019.11.002",

language = "English",

volume = "21",

pages = "843--848",

journal = "Cardiovascular Revascularization Medicine",

issn = "1553-8389",

publisher = "Elsevier",

number = "7",

}

RIS

TY - JOUR

T1 - Jeopardized Myocardium and Survival in Patients Presenting to the Catheterization Laboratory With ST-Elevation Myocardial Infarction and Shock

AU - Joshi, Francis R

AU - Pedersen, Frants

AU - Räder, Sune

AU - Raunsø, Jakob

AU - Kjaergaard, Jesper

AU - Lindholm, Matias

AU - Hassager, Christian

AU - Engstrøm, Thomas

AU - Holmvang, Lene

AU - Helqvist, Steffen

AU - Jørgensen, Erik

PY - 2020/7

Y1 - 2020/7

N2 - OBJECTIVE: We aimed to relate the amount of jeopardized myocardium to mortality in shocked patients presenting to the catheterization laboratory with ST-elevation myocardial infarction (STEMI) and cardiogenic shock.BACKGROUND: In contrast with historical data and previous professional guidance, contemporary randomized data suggest that multi-vessel revascularization in such patients does not improve survival; mechanistic insight is incomplete.METHODS: Clinical databases identified cases of STEMI and shock triaged for primary percutaneous coronary intervention (PPCI) in Eastern Denmark from June 2011 to December 2014 (n = 128). British Cardiovascular Intervention Society (BCIS)-1 jeopardy scores were calculated from angiography. The study endpoint was 30-day mortality.RESULTS: Median lactate values were 6.0 [2.9-10.7] mmol/L. 30-day mortality was 53.9%. 68% of patients had multi-vessel coronary disease. Median pre-PCI BCIS-1 myocardial jeopardy scores were 8 [6-10]. After multiple logistic regression increasing age (p = 0.008; odds ratio [OR] 1.06), lactate values (p = 0.017; OR 1.02), mechanical ventilation (p = 0.011; OR 1.25) and a systolic blood pressure ≤ 90 mmHg at end-case (p = 0.005; OR 1.26) were predictive of 30-day mortality. Post-PPCI culprit vessel TIMI 3 flow was associated with reduced mortality (p < 0.001; OR 0.66). There was no association between pre-PCI jeopardy scores and the primary endpoint.CONCLUSIONS: In patients with STEMI and shock, myocardial jeopardy scores do not relate to patient outcomes. Jeopardy scores may be applied to existing datasets in order to understand why multi-vessel revascularization does not lead to the anticipated clinical benefits in cardiogenic shock.

AB - OBJECTIVE: We aimed to relate the amount of jeopardized myocardium to mortality in shocked patients presenting to the catheterization laboratory with ST-elevation myocardial infarction (STEMI) and cardiogenic shock.BACKGROUND: In contrast with historical data and previous professional guidance, contemporary randomized data suggest that multi-vessel revascularization in such patients does not improve survival; mechanistic insight is incomplete.METHODS: Clinical databases identified cases of STEMI and shock triaged for primary percutaneous coronary intervention (PPCI) in Eastern Denmark from June 2011 to December 2014 (n = 128). British Cardiovascular Intervention Society (BCIS)-1 jeopardy scores were calculated from angiography. The study endpoint was 30-day mortality.RESULTS: Median lactate values were 6.0 [2.9-10.7] mmol/L. 30-day mortality was 53.9%. 68% of patients had multi-vessel coronary disease. Median pre-PCI BCIS-1 myocardial jeopardy scores were 8 [6-10]. After multiple logistic regression increasing age (p = 0.008; odds ratio [OR] 1.06), lactate values (p = 0.017; OR 1.02), mechanical ventilation (p = 0.011; OR 1.25) and a systolic blood pressure ≤ 90 mmHg at end-case (p = 0.005; OR 1.26) were predictive of 30-day mortality. Post-PPCI culprit vessel TIMI 3 flow was associated with reduced mortality (p < 0.001; OR 0.66). There was no association between pre-PCI jeopardy scores and the primary endpoint.CONCLUSIONS: In patients with STEMI and shock, myocardial jeopardy scores do not relate to patient outcomes. Jeopardy scores may be applied to existing datasets in order to understand why multi-vessel revascularization does not lead to the anticipated clinical benefits in cardiogenic shock.

U2 - 10.1016/j.carrev.2019.11.002

DO - 10.1016/j.carrev.2019.11.002

M3 - Journal article

C2 - 31759911

VL - 21

SP - 843

EP - 848

JO - Cardiovascular Revascularization Medicine

JF - Cardiovascular Revascularization Medicine

SN - 1553-8389

IS - 7

ER -

ID: 251792210