Prognostic factors for the early cardiogenic shock in patients with myocardial infarction without shock signs on admission
https://doi.org/10.15829/1728-8800-2026-4517
EDN: KGAZAA
Abstract
Aim. To evaluate the clinical, hemodynamic, and paraclinical characteristics of patients with myocardial infarction (MI) who developed stage B or higher cardiogenic shock (CS) within 48 hours of admission in the absence of shock signs at admission, and to identify factors associated with mortality.
Material and methods. This retrospective analysis included 60 patients. The primary endpoint was inhospital death. Univariable and multivariable logistic regression analyses were used.
Results. Mortality in this cohort of patients was 55%. Independent predictors of mortality in the multivariable model were type 2 diabetes (odds ratio (OR) 149,6; p=0,001) and higher systolic blood pressure on admission (OR 1,08 per 1 mm Hg; p=0,015). Furthermore, achieving optimal reperfusion (Thrombolysis In Myocardial Infarction (TIMI) 3 was an independent protective factor (OR 0,009; p=0,015). The area under the ROC curve for the model was 0,70.
Conclusion. In patients with MI followed by CS, signs of Society for Cardiovascular Angiography and Interventions (SCAI) stage A may be detected already upon admission. These parameters have prognostic significance and can be used for early mortality risk stratification and selection of monitoring strategies.
Keywords
myocardial infarction,
cardiogenic shock,
stage A,
SCAI classification,
prognosis,
diabetes,
regression analysis
Supporting agencies: This work was conducted as part of research under grant № 25-25-00177 of the Russian Science Foundation "Comprehensive assessment of systemic inflammatory response activity in the development and progression of cardiogenic shock in patients with acute coronary syndrome" at the Myocardial Infarction-Associated Shock Laboratory, Cardiology Research Institute, Tomsk National Research Medical Center.
About the Authors
M. A. Kercheva
Cardiology Research Institute, Tomsk National Research Medical Center; Siberian State Medical University
Russian Federation
Russian Federation
Tomsk
S. V. Dil
Cardiology Research Institute, Tomsk National Research Medical Center
Russian Federation
Russian Federation
Tomsk
N. A. Belich
Cardiology Research Institute, Tomsk National Research Medical Center
Russian Federation
Russian Federation
Tomsk
A. F. Kanev
Cardiology Research Institute, Tomsk National Research Medical Center; Siberian State Medical University
Russian Federation
Russian Federation
Tomsk
S. V. Demyanov
Cardiology Research Institute, Tomsk National Research Medical Center
Russian Federation
Russian Federation
Tomsk
V. V. Ryabov
Cardiology Research Institute, Tomsk National Research Medical Center; Siberian State Medical University
Russian Federation
Russian Federation
Tomsk
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What is already known about the subject?
- Cardiogenic shock remains the leading cause of inhospital mortality in myocardial infarction.
- Myocardial reperfusion and microcirculation specify prognosis, but clinical and angiographic predictors of outcome are poorly understood.
What might this study add?
- For the first time, it has been shown that in cardiogenic shock developing in the first 48 hours after myocardial infarction, type 2 diabetes and higher systolic blood pressure on admission are independent predictors of inhospital death.
- Achieving optimal angiographic results (Thrombolysis In Myocardial Infarction 3) is associated with a significant protective effect.
Review
For citations:
Kercheva M.A., Dil S.V., Belich N.A., Kanev A.F., Demyanov S.V., Ryabov V.V. Prognostic factors for the early cardiogenic shock in patients with myocardial infarction without shock signs on admission. Cardiovascular Therapy and Prevention. 2026;25(1):4517. (In Russ.) https://doi.org/10.15829/1728-8800-2026-4517. EDN: KGAZAA
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