Outcomes Associated with Respiratory Failure for Patients with Cardiogenic Shock and Acute Myocardial Infarction: A Substudy of the CULPRIT-SHOCK Trial - Sorbonne Université
Journal Articles Journal of Clinical Medicine Year : 2020

Outcomes Associated with Respiratory Failure for Patients with Cardiogenic Shock and Acute Myocardial Infarction: A Substudy of the CULPRIT-SHOCK Trial

Carlos L Alviar
  • Function : Author
  • PersonId : 1079094
Christopher B Granger
  • Function : Author
  • PersonId : 951019
Stephan Windecker
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  • PersonId : 1079095
Lars Maier
  • Function : Author
  • PersonId : 1079096
Pranas Serpytis
  • Function : Author
  • PersonId : 1079097
Rokas Serpytis
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  • PersonId : 1079098
Keith G Oldroyd
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  • PersonId : 1079099
Marko Noc
  • Function : Author
  • PersonId : 1079100
Georg Fuernau
  • Function : Author
  • PersonId : 1079101
Kurt Huber
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  • PersonId : 1079102
Suzanne de Waha-Thiele
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  • PersonId : 1079104
Steffen Schneider
  • Function : Author
  • PersonId : 1079105
Taoufik Ouarrak
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  • PersonId : 1079106
Uwe Zeymer
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  • PersonId : 1079107

Abstract

Background: Little is known about clinical outcomes of patients with acute myocardial infraction (AMI) complicated by cardiogenic shock (CS) requiring mechanical ventilation (MV). The aim of this study was to identify the characteristics, risk factors, and outcomes associated with the provision of MV in this specific high-risk population. Methods: Patients with CS complicating AMI and multivessel coronary artery disease from the CULPRIT-SHOCK trial were included. We explored 30 days of clinical outcomes in patients not requiring MV, those with MV on admission, and those in whom MV was initiated within the first day after admission. Results: Among 683 randomized patients included in the analysis, 17.4% received no MV, 59.7% were ventilated at admission and 22.8% received MV within or after the first day after admission. Patients requiring MV had a different risk-profile. Factors independently associated with the provision of MV on admission included higher body weight, resuscitation within 24 h before admission, elevated heart rate and evidence of triple vessel disease. Conclusions: Requiring MV in patients with CS complicating AMI is common and independently associated with mortality after adjusting for covariates. Patients with delayed MV initiation appear to be at higher risk of adverse outcomes. Further research is necessary to identify the optimal timing of MV in this high-risk population.
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Dates and versions

hal-02964725 , version 1 (12-10-2020)

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Maria Rubini Giménez, P Elliott Miller, Carlos L Alviar, Sean van Diepen, Christopher B Granger, et al.. Outcomes Associated with Respiratory Failure for Patients with Cardiogenic Shock and Acute Myocardial Infarction: A Substudy of the CULPRIT-SHOCK Trial. Journal of Clinical Medicine, 2020, 9 (3), pp.860. ⟨10.3390/jcm9030860⟩. ⟨hal-02964725⟩
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