Clinical characteristics and prognostic factors in acute coronary syndrome patients complicated with cardiogenic shock in Japan: analysis from the Japanese Circulation Society Cardiovascular Shock Registry

Kazuo Sakamoto, Tetsuya Matoba, Masahiro Mohri, Yasushi Ueki, Yasuyuki Tsujita, Masao Yamasaki, Nobuhiro Tanaka, Yohei Hokama, Motoki Fukutomi, Katsutaka Hashiba, Rei Fukuhara, Satoru Suwa, Hirohide Matsuura, Eizo Tachibana, Naohiro Yonemoto, Ken Nagao

研究成果: ジャーナルへの寄稿記事

抄録

Cardiogenic shock frequently leads to death even with intensive treatment. Although the leading cause of cardiogenic shock is acute coronary syndrome (ACS), the clinical characteristics and the prognosis of ACS with cardiogenic shock in the present era still remain to be elucidated. We analyzed clinical characteristics and predictors of 30-day mortality in ACS with cardiogenic shock in Japan. The Japanese Circulation Society Cardiovascular Shock registry was a prospective, observational, multicenter, cohort study. Between May 2012 and June 2014, 495 ACS patients with cardiogenic shock were analyzed. The primary endpoint was 30-day all-cause mortality. The median [interquartile range; IQR] age was 71.0 [63.0, 80.0] years. The median [IQR] value of systolic blood pressure (SBP) and heart rate were 75.0 [50.0, 86.5] mm Hg and 65.0 [38.0, 98.0] bpm, respectively. Multivariable analysis showed an odds ratio (OR) of 4.76 (confidence intervals; CI 1.97–11.5, p < 0.001) in the lowest SBP category (< 50 mm Hg) for SBP ≥ 90 mm Hg. Moreover, age per 10 years increase (OR 1.38, CI 1.18–1.61, p = 0.002), deep coma (OR 3.49, CI 1.94–6.34, p < 0.001), congestive heart failure (OR 3.81, CI 2.04–7.59, p < 0.001) and left main trunk disease (LMTD) (OR 2.81, CI 1.55–5.10, p < 0.001) were independent predictors. Severe hypotension, older age, deep coma, congestive heart failure, and LMTD were independent unfavorable factors in ACS complicated by cardiogenic shock in Japan. A prompt assessment of high-risk patients referring to those predictors in emergency room could lead to appropriate treatment without delay.

元の言語英語
ジャーナルHeart and Vessels
DOI
出版物ステータス出版済み - 1 1 2019

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Cardiogenic Shock
Acute Coronary Syndrome
Registries
Shock
Japan
Odds Ratio
Blood Pressure
Coma
Hypotension
Heart Failure
Mortality
Multicenter Studies
Hospital Emergency Service
Cohort Studies
Heart Rate
Confidence Intervals
Therapeutics

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

これを引用

Clinical characteristics and prognostic factors in acute coronary syndrome patients complicated with cardiogenic shock in Japan : analysis from the Japanese Circulation Society Cardiovascular Shock Registry. / Sakamoto, Kazuo; Matoba, Tetsuya; Mohri, Masahiro; Ueki, Yasushi; Tsujita, Yasuyuki; Yamasaki, Masao; Tanaka, Nobuhiro; Hokama, Yohei; Fukutomi, Motoki; Hashiba, Katsutaka; Fukuhara, Rei; Suwa, Satoru; Matsuura, Hirohide; Tachibana, Eizo; Yonemoto, Naohiro; Nagao, Ken.

:: Heart and Vessels, 01.01.2019.

研究成果: ジャーナルへの寄稿記事

Sakamoto, Kazuo ; Matoba, Tetsuya ; Mohri, Masahiro ; Ueki, Yasushi ; Tsujita, Yasuyuki ; Yamasaki, Masao ; Tanaka, Nobuhiro ; Hokama, Yohei ; Fukutomi, Motoki ; Hashiba, Katsutaka ; Fukuhara, Rei ; Suwa, Satoru ; Matsuura, Hirohide ; Tachibana, Eizo ; Yonemoto, Naohiro ; Nagao, Ken. / Clinical characteristics and prognostic factors in acute coronary syndrome patients complicated with cardiogenic shock in Japan : analysis from the Japanese Circulation Society Cardiovascular Shock Registry. :: Heart and Vessels. 2019.
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title = "Clinical characteristics and prognostic factors in acute coronary syndrome patients complicated with cardiogenic shock in Japan: analysis from the Japanese Circulation Society Cardiovascular Shock Registry",
abstract = "Cardiogenic shock frequently leads to death even with intensive treatment. Although the leading cause of cardiogenic shock is acute coronary syndrome (ACS), the clinical characteristics and the prognosis of ACS with cardiogenic shock in the present era still remain to be elucidated. We analyzed clinical characteristics and predictors of 30-day mortality in ACS with cardiogenic shock in Japan. The Japanese Circulation Society Cardiovascular Shock registry was a prospective, observational, multicenter, cohort study. Between May 2012 and June 2014, 495 ACS patients with cardiogenic shock were analyzed. The primary endpoint was 30-day all-cause mortality. The median [interquartile range; IQR] age was 71.0 [63.0, 80.0] years. The median [IQR] value of systolic blood pressure (SBP) and heart rate were 75.0 [50.0, 86.5] mm Hg and 65.0 [38.0, 98.0] bpm, respectively. Multivariable analysis showed an odds ratio (OR) of 4.76 (confidence intervals; CI 1.97–11.5, p < 0.001) in the lowest SBP category (< 50 mm Hg) for SBP ≥ 90 mm Hg. Moreover, age per 10 years increase (OR 1.38, CI 1.18–1.61, p = 0.002), deep coma (OR 3.49, CI 1.94–6.34, p < 0.001), congestive heart failure (OR 3.81, CI 2.04–7.59, p < 0.001) and left main trunk disease (LMTD) (OR 2.81, CI 1.55–5.10, p < 0.001) were independent predictors. Severe hypotension, older age, deep coma, congestive heart failure, and LMTD were independent unfavorable factors in ACS complicated by cardiogenic shock in Japan. A prompt assessment of high-risk patients referring to those predictors in emergency room could lead to appropriate treatment without delay.",
author = "Kazuo Sakamoto and Tetsuya Matoba and Masahiro Mohri and Yasushi Ueki and Yasuyuki Tsujita and Masao Yamasaki and Nobuhiro Tanaka and Yohei Hokama and Motoki Fukutomi and Katsutaka Hashiba and Rei Fukuhara and Satoru Suwa and Hirohide Matsuura and Eizo Tachibana and Naohiro Yonemoto and Ken Nagao",
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T1 - Clinical characteristics and prognostic factors in acute coronary syndrome patients complicated with cardiogenic shock in Japan

T2 - analysis from the Japanese Circulation Society Cardiovascular Shock Registry

AU - Sakamoto, Kazuo

AU - Matoba, Tetsuya

AU - Mohri, Masahiro

AU - Ueki, Yasushi

AU - Tsujita, Yasuyuki

AU - Yamasaki, Masao

AU - Tanaka, Nobuhiro

AU - Hokama, Yohei

AU - Fukutomi, Motoki

AU - Hashiba, Katsutaka

AU - Fukuhara, Rei

AU - Suwa, Satoru

AU - Matsuura, Hirohide

AU - Tachibana, Eizo

AU - Yonemoto, Naohiro

AU - Nagao, Ken

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Cardiogenic shock frequently leads to death even with intensive treatment. Although the leading cause of cardiogenic shock is acute coronary syndrome (ACS), the clinical characteristics and the prognosis of ACS with cardiogenic shock in the present era still remain to be elucidated. We analyzed clinical characteristics and predictors of 30-day mortality in ACS with cardiogenic shock in Japan. The Japanese Circulation Society Cardiovascular Shock registry was a prospective, observational, multicenter, cohort study. Between May 2012 and June 2014, 495 ACS patients with cardiogenic shock were analyzed. The primary endpoint was 30-day all-cause mortality. The median [interquartile range; IQR] age was 71.0 [63.0, 80.0] years. The median [IQR] value of systolic blood pressure (SBP) and heart rate were 75.0 [50.0, 86.5] mm Hg and 65.0 [38.0, 98.0] bpm, respectively. Multivariable analysis showed an odds ratio (OR) of 4.76 (confidence intervals; CI 1.97–11.5, p < 0.001) in the lowest SBP category (< 50 mm Hg) for SBP ≥ 90 mm Hg. Moreover, age per 10 years increase (OR 1.38, CI 1.18–1.61, p = 0.002), deep coma (OR 3.49, CI 1.94–6.34, p < 0.001), congestive heart failure (OR 3.81, CI 2.04–7.59, p < 0.001) and left main trunk disease (LMTD) (OR 2.81, CI 1.55–5.10, p < 0.001) were independent predictors. Severe hypotension, older age, deep coma, congestive heart failure, and LMTD were independent unfavorable factors in ACS complicated by cardiogenic shock in Japan. A prompt assessment of high-risk patients referring to those predictors in emergency room could lead to appropriate treatment without delay.

AB - Cardiogenic shock frequently leads to death even with intensive treatment. Although the leading cause of cardiogenic shock is acute coronary syndrome (ACS), the clinical characteristics and the prognosis of ACS with cardiogenic shock in the present era still remain to be elucidated. We analyzed clinical characteristics and predictors of 30-day mortality in ACS with cardiogenic shock in Japan. The Japanese Circulation Society Cardiovascular Shock registry was a prospective, observational, multicenter, cohort study. Between May 2012 and June 2014, 495 ACS patients with cardiogenic shock were analyzed. The primary endpoint was 30-day all-cause mortality. The median [interquartile range; IQR] age was 71.0 [63.0, 80.0] years. The median [IQR] value of systolic blood pressure (SBP) and heart rate were 75.0 [50.0, 86.5] mm Hg and 65.0 [38.0, 98.0] bpm, respectively. Multivariable analysis showed an odds ratio (OR) of 4.76 (confidence intervals; CI 1.97–11.5, p < 0.001) in the lowest SBP category (< 50 mm Hg) for SBP ≥ 90 mm Hg. Moreover, age per 10 years increase (OR 1.38, CI 1.18–1.61, p = 0.002), deep coma (OR 3.49, CI 1.94–6.34, p < 0.001), congestive heart failure (OR 3.81, CI 2.04–7.59, p < 0.001) and left main trunk disease (LMTD) (OR 2.81, CI 1.55–5.10, p < 0.001) were independent predictors. Severe hypotension, older age, deep coma, congestive heart failure, and LMTD were independent unfavorable factors in ACS complicated by cardiogenic shock in Japan. A prompt assessment of high-risk patients referring to those predictors in emergency room could lead to appropriate treatment without delay.

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