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Multivessel Percutaneous Coronary Intervention in Patients With ST-Segment Elevation Myocardial Infarction With Cardiogenic Shock Revascularization Strategies in STEMI with Multivessel Disease: Deciding on Culprit Versus Complete-Ad Hoc or Staged Managing Multivessel Coronary Artery Disease in Patients With ST-Elevation Myocardial Infarction: A Comprehensive Review Early invasive versus non-invasive treatment in patients with non-ST-elevation acute coronary syndrome (FRISC-II): 15 year follow-up of a prospective, randomised, multicentre study Ticagrelor or Prasugrel in Patients with Acute Coronary Syndromes Acute Myocardial Infarction Optimal Timing of Intervention in NSTE-ACS Without Pre-Treatment The EARLY Randomized Trial Response by Kaier et al to Letter Regarding Article, “Direct Comparison of Cardiac Myosin-Binding Protein C With Cardiac Troponins for the Early Diagnosis of Acute Myocardial Infarction” Complete Revascularization Versus Culprit Lesion Only in Patients With ST-Segment Elevation Myocardial Infarction and Multivessel Disease: A DANAMI-3-PRIMULTI Cardiac Magnetic Resonance Substudy Oxygen Therapy in Suspected Acute Myocardial Infarction

Original Research2018 Mar;107(3):233-240.

JOURNAL:Clin Res Cardiol. Article Link

Prognostic impact of atrial fibrillation in cardiogenic shock complicating acute myocardial infarction: a substudy of the IABP-SHOCK II trial

de Waha S, Schoene K, Thiele H et al. Keywords: acute myocardial infarction; atrial fibrillation; cardiogenic shock; IABP-SHOCK II trial; prognosis

ABSTRACT


BACKGROUND - Aim of the current study was to analyse the impact of atrial fibrillation (AF) on prognosis in patients with cardiogenic shock (CS) complicating acute myocardial infarction (AMI), which has never been investigated yet.


METHODS - The current analysis is a substudy of the IABP-SHOCK II trial. Patients were grouped according to the presence or absence of AF. The primary endpoint was all-cause mortality at 30-day follow-up. Secondary endpoints included all-cause mortality, recurrent myocardial infarction, repeat revascularisation, and stroke at 12 months.

 

RESULTS - AF was documented in 28.2% (n = 169) of all 600 patients initially enrolled in the IABP-SHOCK II trial. There were no significant differences with respect to mortality at 30 days and 12 months between patients with and without AF (p = 0.81, p = 0.74). Similarly, the rates of recurrent myocardial infarction, repeat revascularisation, and stroke did not differ between groups (all p > 0.05). There was no interaction of intraaortic balloon counterpulsation (IABP) and no IABP in patients with or without AF with respect to clinical outcome at 30 days and 12 months (p > 0.05).

 

CONCLUSION - AF is not associated with clinical outcome at 30 days and 12 months in CS complicating AMI.