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  • Online Resource  (3)
  • Oxford University Press (OUP)  (3)
  • Ouarrak, Taoufik  (3)
  • 2020-2024  (3)
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  • Online Resource  (3)
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  • Oxford University Press (OUP)  (3)
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  • 2020-2024  (3)
Year
  • 1
    Online Resource
    Online Resource
    Impact of timing of intraaortic balloon counterpulsation on mortality in cardiogenic shock – a subanalysis of the IABP-SHOCK II trial
    Oxford University Press (OUP) ; 2021
    In:  European Heart Journal. Acute Cardiovascular Care Vol. 10, No. 1 ( 2021-03-05), p. 54-61
    Details
    In: European Heart Journal. Acute Cardiovascular Care, Oxford University Press (OUP), Vol. 10, No. 1 ( 2021-03-05), p. 54-61
    Abstract: Conflicting results exist on whether initiation of intraaortic balloon pumping (IABP) before percutaneous coronary intervention (PCI) has an impact on outcome in this setting. Our aim was to assess the outcome of patients undergoing IABP insertion before versus after primary PCI in acute myocardial infarction complicated by cardiogenic shock. Methods The IABP-SHOCK II-trial randomized 600 patients with acute myocardial infarction and cardiogenic shock to IABP-support versus control. We analysed the outcome of patients randomized to the intervention group regarding timing of IABP implantation before or after PCI. Results Of 600 patients included in the IABP-SHOCK II trial, 301 were randomized to IABP-support. We analysed the 275 (91%) patients of this group undergoing primary PCI as revascularization strategy surviving the initial procedure. IABP insertion was performed before PCI in 33 (12%) and after PCI in 242 (88%) patients. There were no differences in baseline arterial lactate (p = 0.70), Simplified Acute Physiology Score-II-score (p = 0.60) and other relevant baseline characteristics. No differences were observed for short- and long-term mortality (pre vs. post 30-day mortality: 36% vs. 37%, odds ratio 0.99, 95% confidence interval (CI) 0.47–2.12, p = 0.99; one-year mortality: 56% vs. 48%, hazard ratio 1.08, 95% CI 0.65–1.80, p = 0.76; six-year-mortality: 64% vs. 65%, hazard ratio 1.00, 95% CI 0.63–1.60, p = 0.99). In multivariable Cox regression analysis timing of IABP-implantation was no predictor for long-term outcome (hazard ratio 1.08, 95% CI 0.66–1.78, p = 0.75). Conclusions Timing of IABP-implantation pre or post primary PCI had no impact on outcome in patients with acute myocardial infarction complicated by cardiogenic shock.
    Type of Medium: Online Resource
    ISSN: 2048-8726 , 2048-8734
    URL: Article
    DOI: 10.1177/2048872620930509
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
    detail.hit.zdb_id: 2663340-1
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  • 2
    Online Resource
    Online Resource
    Comparison of risk prediction models in infarct-related cardiogenic shock
    Oxford University Press (OUP) ; 2021
    In:  European Heart Journal. Acute Cardiovascular Care Vol. 10, No. 8 ( 2021-10-27), p. 890-897
    Details
    In: European Heart Journal. Acute Cardiovascular Care, Oxford University Press (OUP), Vol. 10, No. 8 ( 2021-10-27), p. 890-897
    Abstract: Several prediction models have been developed to allow accurate risk assessment and provide better treatment guidance in patients with infarct-related cardiogenic shock (CS). However, comparative data between these models are still scarce. The objective of the study is to externally validate different risk prediction models in infarct-related CS and compare their predictive value in the early clinical course. Methods and results The Simplified Acute Physiology Score (SAPS) II Score, the CardShock score, the IABP-SHOCK II score, and the Society for Cardiovascular Angiography and Intervention (SCAI) classification were each externally validated in a total of 1055 patients with infarct-related CS enrolled into the randomized CULPRIT-SHOCK trial or the corresponding registry. The primary outcome was 30-day all-cause mortality. Discriminative power was assessed by comparing the area under the curves (AUC) in case of continuous scores. In direct comparison of the continuous scores in a total of 161 patients, the IABP-SHOCK II score revealed best discrimination [area under the curve (AUC = 0.74)], followed by the CardShock score (AUC = 0.69) and the SAPS II score, giving only moderate discrimination (AUC = 0.63). All of the three scores revealed acceptable calibration by Hosmer–Lemeshow test. The SCAI classification as a categorical predictive model displayed good prognostic assessment for the highest risk group (Stage E) but showed poor discrimination between Stages C and D with respect to short-term-mortality. Conclusion Based on the present findings, the IABP-SHOCK II score appears to be the most suitable of the examined models for immediate risk prediction in infarct-related CS. Prospective evaluation of the models, further modification, or even development of new scores might be necessary to reach higher levels of discrimination.
    Type of Medium: Online Resource
    ISSN: 2048-8726 , 2048-8734
    URL: Article
    DOI: 10.1093/ehjacc/zuab054
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
    detail.hit.zdb_id: 2663340-1
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  • 3
    Online Resource
    Online Resource
    Current Spectrum and Outcomes of Infarct-Related Cardiogenic Shock: Insights from the CULPRIT-SHOCK Registry and RCT
    Oxford University Press (OUP) ; 2024
    In:  European Heart Journal: Acute Cardiovascular Care ( 2024-02-13)
    Details
    In: European Heart Journal: Acute Cardiovascular Care, Oxford University Press (OUP), ( 2024-02-13)
    Abstract: We analysed consecutive patients with acute myocardial infarction complicated by cardiogenic shock (CS) who were enrolled into the CULPRIT-SHOCK randomized controlled trial (RCT) and those with exclusion criteria who were included into the accompanying registry. Methods In total, 1,075 patients with infarct-related CS were screened for CULPRIT-SHOCK in 83 specialised centres in Europe; 369 of them had exclusion criteria for the RCT and were enrolled into the registry. Patients were followed over 1-year. Results Mean age was 68 years and 260 (25 %) were women. 13.5 %, 30.9 %, and 55.6 % had 1-vessel, 2-vessel, and 3-vessel coronary artery disease (CAD), respectively. Significant left main (LM) coronary artery stenosis was present in 8.0 %. 54.2 % of the patients had cardiac arrest before admission. TIMI 3 patency of the infarct vessel after PCI was achieved in 83.6 % of all patients. Mechanical circulatory support was applied in one third of patients. Total mortality after 30 days and one year was 47.6 % and 52.9 %. Mortality after one year was highest in patients with LM coronary artery stenosis (63.5 %), followed by 3-vessel- (56.6 %), 2-vessel- (49.8 %), and 1-vessel-CAD (38.6 %), respectively. Mechanical complications were rare (21/1008; 2.1 %) but associated with a high mortality of 66.7 % after 1 year. Conclusions In specialised centres in Europe short- and long-term mortality of patients with infarct-related CS treated with an invasive strategy is still high and mainly depending on the extent of coronary artery disease. Therefore, there is still need for improvement of care to improve prognosis of infarct-related CS.
    Type of Medium: Online Resource
    ISSN: 2048-8726 , 2048-8734
    URL: Article
    DOI: 10.1093/ehjacc/zuae020
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2024
    detail.hit.zdb_id: 2663340-1
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    Online Resource
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