scholarly journals Acute heart failure following myocardial infarction: complement activation correlates with the severity of heart failure in patients developing cardiogenic shock

2018 ◽  
Vol 5 (3) ◽  
pp. 292-301 ◽  
Author(s):  
Hilde L. Orrem ◽  
Per H. Nilsson ◽  
Søren E. Pischke ◽  
Guro Grindheim ◽  
Peter Garred ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Cardiogenic Shock ◽  
Acute Heart Failure ◽  
Complement Activation

Complement activation in acute heart failure following myocardial infarction

Immunobiology ◽  
2016 ◽  
Vol 221 (10) ◽  
pp. 1203-1204
Author(s):  
Hilde L. Orrem ◽  
Per H. Nilsson ◽  
Andreas Barratt-Due ◽  
Søren E. Pische ◽  
Guro Grindheim ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Heart Failure ◽  
Complement Activation

scholarly journals Short‐ and Long‐Term Clinical Outcomes for Patients With Takotsubo Syndrome and Patients With Myocardial Infarction: A Report From the Swedish Coronary Angiography and Angioplasty Registry

2021 ◽  
Vol 10 (17) ◽  
Author(s):  
Björn Redfors ◽  
Sandeep Jha ◽  
Sigurdur Thorleifsson ◽  
Tomas Jernberg ◽  
Oskar Angerås ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Coronary Angiography ◽  
Cardiogenic Shock ◽  
Acute Heart Failure ◽  
Mortality Risk ◽  
Takotsubo Syndrome ◽  
Killip Class ◽  
St Segment Elevation ◽  
Similar Risk

Background Takotsubo syndrome (TS) is a potentially life‐threatening acute cardiac syndrome with a clinical presentation similar to myocardial infarction and for which the natural history, management, and outcome remain incompletely understood. Our aim was to assess the relative short‐term mortality risk of TS, ST‐segment–elevation myocardial infarction (STEMI), and non‐STEMI (NSTEMI) and to identify predictors of in‐hospital complications and poor prognosis in patients with TS. Methods and Results This is an observational cohort study based on the data from the SCAAR (Swedish Coronary Angiography and Angioplasty Registry). We included all patients (n=117 720) who underwent coronary angiography in Sweden attributed to TS (N=2898 [2.5%]), STEMI (N=48 493 [41.2%]), or NSTEMI (N=66 329 [56.3%]) between January 2009 and February 2018. We compared patients with TS to those with NSTEMI or STEMI. The primary end point was all‐cause mortality at 30 days. Secondary outcomes were acute heart failure (Killip Class ≥2) and cardiogenic shock (Killip Class 4) at the time of angiography. Patients with TS were more often women compared with patients with STEMI or NSTEMI. TS was associated with unadjusted and adjusted 30‐day mortality risks lower than STEMI (adjusted hazard ratio [adjHR], 0.60; 95% CI, 0.48–0.76; P <0.001), but higher than NSTEMI (adjHR, 2.70; 95% CI, 2.14–3.41; P <0.001). Compared with STEMI, TS was associated with a similar risk of acute heart failure (adjHR, 1.26; 95% CI, 0.91–1.76; P =0.16) but a lower risk of cardiogenic shock (adjHR, 0.55; 95% CI, 0.34–0.89; P =0.02). The relative 30‐day mortality risk for TS versus STEMI and NSTEMI was higher for smokers than nonsmokers (adjusted P interaction STEMI=0.01 and P interaction NSTEMI=0.01). Conclusions The 30‐day mortality rate in TS was higher than in NSTEMI but lower than STEMI despite a similar risk of acute heart failure in TS and STEMI. Among patients with TS, smoking was an independent predictor of mortality.

scholarly journals Single-centre experience with the Impella CP, 5.0 and RP in 109 consecutive patients with profound cardiogenic shock

2017 ◽  
Vol 7 (1) ◽  
pp. 53-61 ◽  
Author(s):  
Peter Blom Jensen ◽  
Sigrun Høegholm Kann ◽  
Karsten Tange Veien ◽  
Ole Kristian Møller-Helgestad ◽  
Jordi Sanchez Dahl ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Cardiogenic Shock ◽  
Acute Heart Failure ◽  
Insertion Site ◽  
Real Life ◽  
Early Death ◽  
Circulatory Support ◽  
Complication Rates ◽  
Aggressive Approach

Rationale: Short-term mechanical circulatory support is increasingly used in the management of cardiogenic shock, but data from controlled studies are sparse. Thus, real-life data on complication rates and predictors of adverse outcome are important. Objective: The objective of this study was to analyse the experience with Impella devices in the management of profound cardiogenic shock. Methods and results: A retrospective study of 109 consecutive patients with severe shock after myocardial infarction, acute heart failure, or cardiac surgery. Possible device-related complications were registered and predictors of death while on Impella support and within 180 days were identified. In 79 patients (72%) cardiogenic shock was caused by myocardial infarction, acute heart failure in 16 (15%) and post-cardiotomy shock in 14 patients (13%). Thirty-five patients (32%) were comatose after cardiac arrest and in seven, the Impella was placed during chest compression. Mean age was 62±12 years, mean arterial pressure was 57±13 mmHg, pH 7.19±0.17 and lactate 7.5±5.7 mmol/l (range 1.8–30.0 mmol/l) at placement. During Impella therapy, 26 patients (28%) died among patients with myocardial infarction or acute heart failure. Of data available prior to placement lactate (hazard ratio 1.14, 95% confidence interval 1.04–1.25, P=0.004) was the only predictor of death on support. During support, five patients (5%) developed leg ischaemia requiring intervention. Bleeding from the Impella insertion site was seen in 14 patients (13%). Conclusion: Impella treatment is feasible in profound cardiogenic shock at an acceptable rate of complications. Despite an aggressive approach to restore cardiac output, mortality was high. Besides the severity of lactic acidosis there were no strong predictors of early death.

P1727Prognosis predictors of patients with initial cardiogenic shock complicated acute myocardial infarction treated with primary angioplasty and intense antiplatelet therapy. PRAGUE-18 shock substudy

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
O Hlinomaz ◽  
Z Motovska ◽  
J Knot ◽  
R Miklik ◽  
M Hromadka ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Myocardial Infarction ◽  
Cardiogenic Shock ◽  
Acute Heart Failure ◽  
Bypass Graft ◽  
Primary Pci ◽  
Early Reperfusion ◽  
Entire Study ◽  
Infarct Related Artery

Abstract Background Early reperfusion of the infarct related artery is the only treatment improving prognosis of patients with initial cardiogenic shock (CGS) complicated acute myocardial infarction (AMI) (Killip class IV at admission). Purpose The analysis focused on subgroup of patients with initial CGS randomized into the multicenter PRAGUE-18 study (prasugrel vs. ticagrelor in primary PCI). Methods In the PRAGUE-18 study, patients with acute myocardial infarction (AMI) (n=1230) treated with primary percutaneous coronary intervention (pPCI) were immediately randomized to prasugrel or ticagrelor with intended treatment duration of 12 months. 53.6% (n=659) switched to clopidogrel after discharge. Major ischemic and bleeding events were followed throughout the entire study period. Beside standard laboratory tests, efficacy of ticagrelor and prasugrel was measured by flow cytometric VASP evaluation in patients selected for a laboratory sub-study (n=218). Acute heart failure (KILLIP >1) was present in 11.8%, and 46 patients (3.7%) randomized to the study were in CGS. Results Patients with CGS were older [66.7 (48,3; 83,3) years] than those without CGS (KILLIP <4), and had the highest prevalence of bundle brunch block on the initial ECG (RBBB in 6.5%, LBBB in 8.7%, p=0.003 for difference in bundle brunch blocks). Time delay to hospital admission [1,7 (0,4; 36,0) hs] was significantly shorter than in patients KILLIP <4 [2,8 (0,8; 28,3hs; p=0.003]. Significantly more CGS patients had history of previous MI (19.6% vs 7.9%, p=0.011) and bypass graft surgery (6.5% vs 1.5%, p=0.041). 67.4% of CGS patients had multivessel disease and in 17.4% of these patients primary PCI was evaluated as suboptimal result or procedural failure (compared to 4.3% in patients without shock, p<0.001). No difference was observed in clinical (primary and secondary endpoints, p=0.564) or laboratory efficacy between prasugrel and ticagrelor treated patients with CGS (p=0.800 for VASP index difference between prasugrel and ticagrelor 20±4 hs after loading doses). We did not find any difference in initial platelet activation (VASP index before P2Y12 inhibitors administration) in patients without acute heart failure (KILLIP I) [83.2 (54.1–94.2) %] and with KILLIP > I [82.5 (65.7–96.9), p=0.999], and this was also confirmed for the difference between KILLIP I and KILLIP IV patients (p=0.416). Conclusion Results of the present analysis and defined predictors of mortality showed that prognosis of patients with initial cardiogenic complicated AMI treated with pPCI cannot be influenced by more potent platelet inhibition (than in AMI patients without CGS). Furthermore, the concluding evidence underscored adherence to the current guidelines' recommendation of the earliest possible reperfusion of infarct related artery as well as administration of prasugrel or ticagrelor.

scholarly journals Association of Interleukin 8 and Myocardial Recovery in Patients with ST-Elevation Myocardial Infarction Complicated by Acute Heart Failure

PLoS ONE ◽  
2014 ◽  
Vol 9 (11) ◽  
pp. e112359 ◽  
Author(s):  
Trygve Husebye ◽  
Jan Eritsland ◽  
Harald Arnesen ◽  
Reidar Bjørnerheim ◽  
Arild Mangschau ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Heart Failure ◽  
Interleukin 8 ◽  
St Elevation Myocardial Infarction ◽  
Myocardial Recovery ◽  
St Elevation

scholarly journals P602Growth differentiation factor-15 predicts mortality in acute heart failure and cardiogenic shock

2017 ◽  
Vol 38 (suppl_1) ◽  
Author(s):  
W.S. Speidl ◽  
S.P. Kastl ◽  
K.A. Krychtiuk ◽  
M. Lenz ◽  
J. Wojta ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiogenic Shock ◽  
Acute Heart Failure ◽  
Differentiation Factor
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