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In-hospital outcomes of acute myocardial infarction with cardiogenic shock caused by right coronary artery occlusion vs. left coronary artery occlusion

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Abstract

In-hospital outcomes of acute myocardial infarction (AMI) with cardiogenic shock (CS) were still not satisfactory even in the primary percutaneous coronary intervention (PCI) era. The aim of this study was to compare in-hospital outcomes of AMI with CS caused by right coronary artery (RCA) occlusion vs. left coronary artery (LCA) occlusion. Consecutive 894 AMI patients from January 2010 to March 2015 were screened for inclusion. A total of 114 AMI patients with CS were included as the final study population, and were divided into the RCA group (n = 56) and LCA group (n = 58). The patient characteristics were compared between the two groups. Multivariate logistic regression analysis was performed to show whether the RCA group was associated with better outcomes even after controlling confounding factors. In-hospital mortality was significantly lower in the RCA group (8.9%) than in the LCA group (46.6%) (P < 0.001). The RCA group (vs. the LCA group) was inversely associated with in-hospital death (OR 0.08, 95% CI 0.02–0.21, P < 0.001) after controlling covariates. Aspartate transaminase value (per 50 U/L incremental: OR 1.22, 95% CI 1.03–1.45, P = 0.02), aging (per 10-year-old incremental: OR 2.14, 95% CI 1.26–3.63, P = 0.01) and using VA-ECMO (OR 22.13, 95% CI 5.22–93.90, P < 0.001) were also significantly associated with in-hospital death. In conclusion, among AMI patients with CS, IRA of RCA was significantly associated with the better in-hospital outcome.

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Authors and Affiliations

  1. Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, Saitama, 330-8503, Japan

    Yousuke Taniguchi, Kenichi Sakakura, Yusuke Adachi, Naoyuki Akashi, Yusuke Watanabe, Masamitsu Noguchi, Kei Yamamoto, Yusuke Ugata, Hiroshi Wada, Shin-ichi Momomura & Hideo Fujita

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  1. Yousuke Taniguchi
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  2. Kenichi Sakakura
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  3. Yusuke Adachi
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  4. Naoyuki Akashi
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  5. Yusuke Watanabe
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  6. Masamitsu Noguchi
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  7. Kei Yamamoto
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  11. Hideo Fujita
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Correspondence to Kenichi Sakakura.

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The authors declare that they have no conflict of interests.

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All procedures performed in studies involving human participants were in accordance with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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This study was approved by the institutional review board, and written informed consent was waived because of the retrospective study design.

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Taniguchi, Y., Sakakura, K., Adachi, Y. et al. In-hospital outcomes of acute myocardial infarction with cardiogenic shock caused by right coronary artery occlusion vs. left coronary artery occlusion. Cardiovasc Interv and Ther 33, 338–344 (2018). https://doi.org/10.1007/s12928-017-0490-9

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  • DOI: https://doi.org/10.1007/s12928-017-0490-9

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