Predictors of Cardiogenic Shock During or After Percutaneous Coronary Intervention in Patients with Acute Coronary Syndrome
Keywords:
Cardiogenic shock, Percutaneous coronary intervention, Acute coronary syndromeAbstract
Background and Objectives Cardiogenic shock is a severe and life-threatening condition. This study aimed to investigate the predictors of cardiogenic shock during or after percutaneous coronary intervention in patients with acute coronary syndrome.
Methods This paper was a retrospective cohort study that analyzes secondary data from the main research project on the prevalence of bleeding and the analysis of relationship predictors for bleeding in patients with acute coronary syndrome after percutaneous coronary intervention. The sample group consisted of 295 patients with acute coronary syndrome who underwent percutaneous coronary intervention at a secondary hospital. Data analysis was performed using binary logistic regression.
Results The study found that 134 patients with acute coronary syndrome during hospitalization, representing 45.4%, developed cardiogenic shock during or after percutaneous coronary intervention (PCI). Factors that predicted the occurrence of cardiogenic shock during or after PCI were cardiogenic shock before PCI (adjusted OR = 8.44, 95% CI: 4.09–17.40), arrhythmias (adjusted OR = 2.09, 95% CI: 1.17–3.71), and procedure time (adjusted OR = 1.02, 95% CI: 1.00–1.03).
Conclusion and Recommendations The study results indicate that if the occurrence of cardiogenic shock before percutaneous coronary intervention and arrhythmias can be prevented, as well as if procedure time can be reduced, this may help decrease the incidence of cardiogenic shock during or after percutaneous coronary intervention.
References
Aissaoui, N., Puymirat, E., Delmas, C., Ortuno, S., Durand, E., Bataille, V., Drouet, L., Bonello, L., Bonnefoy-Cudraz, E., Lesmeies, G., Guerot, E., Schiele, F., Simon, T., & Danchin, N. (2020). Trends in cardiogenic shock complicating acute myocardial infarction. Europeanjournal of heart failure, 22(4), 664 - 672. https://doi.org/10.1002/ejhf.1750
Acharya, D. (2018). Predictors of outcomes in myocardial infarction and cardiogenic shock. Cardiology in review, 26(5), 255-266. https://pmc.ncbi.nlm.nih.gov/articles/PMC6082598 /pdf/crd-26-255.pdf
American Heart Association. (2022). Management of cardiogenic shock: A scientific statement. Circulation, 145(6), e232 – e268. https://doi.org/10.1161/CIR.0000000000000525
Chitsomkasem, A. (2017). Cardiogenic Shock. Thai Journal of Critical Care Medicine, 25(2), 10 - 23. https://he02.tci-thaijo.org/index.php/ccc/article/view/250155/170015
European Society of Cardiology. (2023). ESC Guidelines on acute and chronic heart failure. European Heart Journal, 44(1), 58 - 158. https://doi.org/10.1093/eurheartj/ehad191
Frydland, M., Møller, J. E., Lindholm, M. G., Hansen, R., Wiberg, S., Lerche Helgestad, O., Thomsen, J.H., Goetze, J.P., Engstrom, T., Frikke-Scmidt, R., Ravn, H.B., Holmvang, L., Jensen, L.O., Kjaergaard, J., & Hassager, C. (2020). Biomarkers predictive of late cardiogenic shock development in patients with suspected ST-elevation myocardial infarction. European Heart ournal: Acute Cardiovascular Care, 9(6), 557-566. https://doi.org/10.1177/2048872619896063
Gorenek, B., Blomström Lundqvist, C., Terradellas, J.B., Camm, A. J., Hindricks, G., Huber, K., Kirchhof, P., Kuck, K.H., Kudaiberdieva, G., Lin, T., Raviele, A., Santini, M., Tilz, R.R., Valgimigli, M., Vos, M.A., Vrints, C., Zeymer, U., ... & Kristiansen, S.B. (2014). Cardiac arrhythmias in acute coronary syndromes: position paper from the joint EHRA, ACCA, and EAPCI task force. EP Europace, 16(11), 1655-1673. https://doi.org/10.1093/europace/euu208
Jung, R. G., Di Santo, P., Mathew, R., Simard, T., Parlow, S., Weng, W., Abdel-Razek, O., Malhotra, N., Cheung, M., Hutson, J.H., Marbach, J.A., Motazedian, P., Thibert, M.J., Fernando, S.M., Nery, P.B., Nair, G.M., Russo, J.J., Hibbert, B., ... & Ramirez, F. D. (2023). Arrhythmic events and mortality in patients with cardiogenic shock on inotropic support: Results of the DOREMI randomized trial. Canadian Journal of Cardiology, 39(4), 394- 402. https://doi.org/10.1016/j.cjca.2022.09.013
Kosaraju, A., Pendela, V, S., & Hai, O. (2024) Cardiogenic shock. StatPearls Publishing.
Kumthree, W. (2020). Predicting mortality in acute coronary syndrome with cardiogenic shock treated with percutaneous coronary intervention and intra-aortic balloon pump. Udonthani Hospital Medical Journal, 28(2), 159 - 168. https://he02.tci-thaijo.org/index.php/udhhosmj/article/download/245089/166627
Lee, K. H., Harrison, W., Chow, K. L., Lee, M., & Kerr, A. J. (2024). Cardiogenic shock prior to percutaneous coronary intervention in ST-elevation myocardial infarction: outcomes and predictors of mortality (ANZACS-QI 73). Heart, Lung and Circulation, 33(4), 450 - 459. https://doi.org/10.1016/j.hlc.2024.01.009
Nallamothu, B. K., Normand, S.T., Wang, Y., Hofer, T.P., Brush, J.E., Messenger, J.C., Bradley, E.H., Rumsfeld, J.S., & Krumholz, H. M. (2015). Relation between door-to-balloon times and mortality after primary percutaneous coronary intervention over time: a retrospective study. The Lancet, 385(9973), 1114-1122. https://doi.org/10.1016/S0140-6736(14)61932-2
Nguyen, H. L., Yarzebski, J., Lessard, D., Gore, J. M., McManus, D.D., & Goldberg, R.J. (2017). Ten Year (2001–2011) trends in the incidence rates and Short Term outcomes of early versus late onset cardiogenic shock after hospitalization for acute myocardial infarction. Journal of the American Heart Association, 6(6), e005566. https://doi.org/10.1161/JAHA.117.005566
Obling, L., Frydland, M., Hansen, R., Møller-Helgestad, O.K., Lindholm, M.G., Holmvang, L., Ravn, H.B., Wiberg, S., Thomsen, J.H., Jensen, L.O., Kjaergaard, J., Moller, J.E., & Hassager, C. (2018). Risk factors of late cardiogenic shock and mortality in ST-segment elevation myocardial infarction patients. European heart journal: acute cardiovascular care, 7(1),
- 15. https://doi.org/10.1177/2048872617706503
Osman, M., Syed, M., Patibandla, S., Sulaiman, S., Kheiri, B., Shah, M.K., Bianco, C., & Balla, S. (2021). Fifteen year trends in incidence of cardiogenic shock hospitalization and in hospital mortality in the United States. Journal of the American Heart Association, 10(15), e021061. https://doi.org/10.1161/JAHA.121.021061
Pattanajak, C., Sanmaung, A., & Kiatchoosakun S. (2019). In-Hospital Complications of Coronary angiogram and Percutaneous Coronary Intervention: Essential for cardiovascular urses. Mahasarakham Hospital Journal, 16(2), 50 - 61. https://he02.tci-thaijo.org/index.php /MKHJ/article/download/219826/152111
Pekkarinen, P. T., Bäcklund, M., Efendijev, I., Raj, R., Folger, D., Litonius, E., Laitio, R., Bendel, S., Hoppu, S., Ala-Kokko, T., Reimikaimen, M., ... & Skrifvars, M. B. (2019). Association of extracerebral organ failure with 1-year survival and healthcare-associated costs after cardiac arrest: an observational database study. Critical Care, 23(67), 1-10. https://doi.org/10.1186/s13054-019-2359-z
Poonsong, C., Phonphet, C., Suwanno, J., & Chaimay, B. (2022). Prevalence and gender difference in bleeding events among acute coronary syndrome patients after percutaneous coronary intervention. Thai Journal of Cardio-Thoracic Nursing, 33(1), 132 - 148. http://share.google/ 0awZj8RS2thlAYMuC
Samsky, M.D., Morrow, D.A., Proudfoot, A.G., Hochman, J.S., Thiele, H., & Rao, S.V. (2021). Cardiogenic shock after acute myocardial infarction: a review. Jama, 326(18), 1840 - 1850. https://doi.org/10.1001/jama.2021.18323
Sinha, S.S., Morrow, D.A., Kapur, N.K., Kataria, R., & Roswell, R.O. (2025). 2025 Concise Clinical Guidance: An ACC Expert Consensus Statement on the Evaluation and Management of Cardiogenic Shock: A Report of the American College of Cardiology Solution Set Oversight Committee. Journal of the American College of Cardiology. 85(16), 1618 - 1641 http://doi.org/10.1016/j.jacc.2025.02.018?utm_source=chatgpt.com
Thiele, H., Desch, S., Piek, J. J., Stepinska, J., Oldroyd, K., & Serpytis, P., (2016). Multivessel versus culprit lesion only percutaneous revascularization plus potential staged revascularization in patients with acute myocardial infarction omplicated by cardiogenic shock: design and rationale of CULPRIT-SHOCK trial. American heart journal, 172, 160 - 169. https://doi.org/10.1016/j.ahj.2015.11.006
Thiele, H., & Zeymer, U. (2018). The ESC Textbook of Intensive and Acute Cardiovascular Care
(2nd ed.). European Society of Cardiology. https://doi.org/10.1093/med/9780199687039.003. 0049_update_003
Theofilis, P., Oikonomou, E., Chasikidis, C., Tsioufis, K., & Tousoulis, D. (2023). Pathophysiology of acute coronary syndromes-Diagnostic and treatment considerations. Life, 13(7), 1543. https://www.mdpi.com/2075-1729/13/7/1543
Van Diepen, S., Katz, J. N., Albert, N. M., Henry, T. D., Jacobs, A. K., Kapur, N. K., Kilic, A., Menon, V., Ohman, M., Sweitzer, N.K., Thiele, H., Washam, J.B., Faha, P.D., & Cohen,M. G. (2017). Contemporary management of cardiogenic shock: a scientific statement from the American Heart Association. Circulation, 136(16), e232-e268. https://doi.org/10.1161/CIR.0000000000000525
Weipert, K. F., Bauer, T., Nef, H. M., Hochadel, M., Weidinger, F., Gitt, A. K., ... & Hamm, C. W. (2020). Incidence and outcome of peri-procedural cardiogenic shock: results from the international Euro Heart Survey PCI registry. European Heart Journal: Acute Cardiovascular Care, 9(2), 120 - 127. https://doi.org/10.1177/2048872618822460
Wongpraparut, N., Chotinaiwattarakul, C., Panchavinnin, P., Tresukosol, D., Phankingthongkum, R., & Tungsubutra, W. (2014). First medical contact to device time in the Thailand Percutaneous Coronary Intervention (PCI) registry. Journal of the Medical Association of Thailand, 97(12), 1247 - 1253. https://www.thaiscience.info/Journals/Article/JMAT/10970989.pdf
Zeymer, U., Bueno, H., Granger, C. B., Hochman, J., Huber, K., Lettino, M., Price, S., Schiele, F., Tubaro, M., Vranckx, P., Zahger, D., & Thiele, H. (2020). Acute Cardiovascular Care Association position statement for the diagnosis and treatment of patients with acute myocardial infarction complicated by cardiogenic shock: A document of the Acute Cardiovascular Care Association of the European Society of Cardiology. European Heart Journal: Acute Cardiovascular Care, 9(2), 183-197. https://doi.org/10.1177/2048872619894254
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Princess of Naradhiwas University Journal
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
