BACKGROUND: Although cardiogenic shock (CS) is the leading cause of death for acute myocardial infarction (AMI) patients, reliable predictive factors in the acute stage, such as cardiovascular peptides, have not yet been identified. METHODS AND RESULTS: In 42 consecutive AMI patients with CS on admission, successfully treated by primary percutaneous coronary intervention (PCI) within 12 h of onset, related factors including brain natriuretic peptide (BNP), atrial natriuretic peptide (ANP), renin, aldosterone, catecholamines, and adrenomedullin, were investigated 24 h from onset, as well as the 1-year mortality rates. During the 12-month follow-up period, 15 patients died from cardiovascular causes (group D). There were no significant differences in patient characteristics, angiographic findings, and left ventricular systolic function between group D subjects and the survivors (group S: n=27). Multivariate analysis identified high levels of adrenomedullin as an independent predictor of 1-year mortality (risk ratio: 6.42, 95% confidence interval, 1.49-43.31, p<0.05). CONCLUSIONS: The acute-phase plasma concentration of adrenomedullin may be a reliable predictor of mortality in patients with AMI complicated by CS and successfully treated by direct PCI, as may be BNP concentration, peak-creatine kinase value, and ventricular fibrillation.
BACKGROUND: Although cardiogenic shock (CS) is the leading cause of death for acute myocardial infarction (AMI) patients, reliable predictive factors in the acute stage, such as cardiovascular peptides, have not yet been identified. METHODS AND RESULTS: In 42 consecutive AMI patients with CS on admission, successfully treated by primary percutaneous coronary intervention (PCI) within 12 h of onset, related factors including brain natriuretic peptide (BNP), atrial natriuretic peptide (ANP), renin, aldosterone, catecholamines, and adrenomedullin, were investigated 24 h from onset, as well as the 1-year mortality rates. During the 12-month follow-up period, 15 patients died from cardiovascular causes (group D). There were no significant differences in patient characteristics, angiographic findings, and left ventricular systolic function between group D subjects and the survivors (group S: n=27). Multivariate analysis identified high levels of adrenomedullin as an independent predictor of 1-year mortality (risk ratio: 6.42, 95% confidence interval, 1.49-43.31, p<0.05). CONCLUSIONS: The acute-phase plasma concentration of adrenomedullin may be a reliable predictor of mortality in patients with AMI complicated by CS and successfully treated by direct PCI, as may be BNP concentration, peak-creatine kinase value, and ventricular fibrillation.
Authors: C Lüers; A Schmidt; R Wachter; F Fritzsche; A Sutcliffe; S Kleta; A Zapf; G Hagenah; L Binder; B Maisch; B Pieske Journal: Herz Date: 2010-10 Impact factor: 1.443
Authors: Zofia Dzielińska; Lukasz A Małek; Andrzej Januszewicz; Aleksander Prejbisz; Jerzy Pręgowski; Paweł Tyczyński; Magdalena Makowiecka-Cieśla; Jadwiga Janas; Marcin Demkow; Witold Ruzyłło Journal: Arch Med Sci Date: 2011-12-30 Impact factor: 3.318
Authors: Heli Tolppanen; Mercedes Rivas-Lasarte; Johan Lassus; Jordi Sans-Roselló; Oliver Hartmann; Matias Lindholm; Mattia Arrigo; Tuukka Tarvasmäki; Lars Köber; Holger Thiele; Kari Pulkki; Jindrich Spinar; John Parissis; Marek Banaszewski; Jose Silva-Cardoso; Valentina Carubelli; Alessandro Sionis; Veli-Pekka Harjola; Alexandre Mebazaa Journal: Ann Intensive Care Date: 2017-01-04 Impact factor: 6.925