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In-hospital mortality of cardiogenic shock complicating ST-elevation myocardial infarction in Malaysia: a retrospective analysis of the Malaysian National Cardiovascular Database (NCVD) registry

Objectives Cardiogenic shock (CS) complicating ST-elevation myocardial infarction (STEMI) carries an extremely high mortality. The clinical pattern of this life threatening complication has never been described in Malaysian setting. This study is to investigate the incidence, clinical characteristic...

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Main Authors: Venkatason, Padmaa, Zubairi, Yong Zulina, Wan Ahmad, Wan Azman, Hafidz, Muhammad Imran Abdul, Ismail, Muhammad Dzafir, Hadi, Mohd Firdaus, Zuhdi, Ahmad Syadi Mahmood
Format: Article
Published: BMJ Publishing Group 2019
Subjects:
QA Mathematics
R Medicine
Online Access:http://eprints.um.edu.my/23201/
https://doi.org/10.1136/bmjopen-2018-025734
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spelling my.um.eprints.232012019-12-04T01:57:25Z http://eprints.um.edu.my/23201/ In-hospital mortality of cardiogenic shock complicating ST-elevation myocardial infarction in Malaysia: a retrospective analysis of the Malaysian National Cardiovascular Database (NCVD) registry Venkatason, Padmaa Zubairi, Yong Zulina Wan Ahmad, Wan Azman Hafidz, Muhammad Imran Abdul Ismail, Muhammad Dzafir Hadi, Mohd Firdaus Zuhdi, Ahmad Syadi Mahmood QA Mathematics R Medicine Objectives Cardiogenic shock (CS) complicating ST-elevation myocardial infarction (STEMI) carries an extremely high mortality. The clinical pattern of this life threatening complication has never been described in Malaysian setting. This study is to investigate the incidence, clinical characteristics and outcome of STEMI patients with CS in our population. Design A retrospective analysis of STEMI patients from 18 hospitals across Malaysia contributing to the Malaysian National Cardiovascular Database-acute coronary syndrome) registry (NCVD-ACS) year 2006-2013. Participants 16 517 patients diagnosed of STEMI from 18 hospitals in Malaysia from the year 2006 to 2013. Primary outcome measures In-hospital and 30 day post-discharge mortality. Results CS complicates 10.6% of all STEMIs in this study. They had unfavourable premorbid conditions and poor outcomes. The in-hospital mortality rate was 34.1% which translates into a 7.14 times mortality risk increment compared with STEMI without CS. Intravenous thrombolysis remained as the main urgent reperfusion modality. Percutaneous coronary interventions (PCI) in CS conferred a 40% risk reduction over non-invasive therapy but were only done in 33.6% of cases. Age over 65, diabetes mellitus, hypertension, chronic lung and kidney disease conferred higher risk of mortality. Conclusion Mortality rates of CS complicating STEMI in Malaysia are high. In-hospital PCI confers a 40% mortality risk reduction but the rate of PCI among our patients with CS complicating STEMI is still low. Efforts are being made to increase access to invasive therapy for these patients. © 2019 Author(s) (or their employer(s)). Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. BMJ Publishing Group 2019 Article PeerReviewed Venkatason, Padmaa and Zubairi, Yong Zulina and Wan Ahmad, Wan Azman and Hafidz, Muhammad Imran Abdul and Ismail, Muhammad Dzafir and Hadi, Mohd Firdaus and Zuhdi, Ahmad Syadi Mahmood (2019) In-hospital mortality of cardiogenic shock complicating ST-elevation myocardial infarction in Malaysia: a retrospective analysis of the Malaysian National Cardiovascular Database (NCVD) registry. BMJ Open, 9 (5). e025734. ISSN 2044-6055 https://doi.org/10.1136/bmjopen-2018-025734 doi:10.1136/bmjopen-2018-025734
institution Universiti Malaya
building UM Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider Universiti Malaya
content_source UM Research Repository
url_provider http://eprints.um.edu.my/
topic QA Mathematics
R Medicine
spellingShingle QA Mathematics
R Medicine
Venkatason, Padmaa
Zubairi, Yong Zulina
Wan Ahmad, Wan Azman
Hafidz, Muhammad Imran Abdul
Ismail, Muhammad Dzafir
Hadi, Mohd Firdaus
Zuhdi, Ahmad Syadi Mahmood
In-hospital mortality of cardiogenic shock complicating ST-elevation myocardial infarction in Malaysia: a retrospective analysis of the Malaysian National Cardiovascular Database (NCVD) registry
description Objectives Cardiogenic shock (CS) complicating ST-elevation myocardial infarction (STEMI) carries an extremely high mortality. The clinical pattern of this life threatening complication has never been described in Malaysian setting. This study is to investigate the incidence, clinical characteristics and outcome of STEMI patients with CS in our population. Design A retrospective analysis of STEMI patients from 18 hospitals across Malaysia contributing to the Malaysian National Cardiovascular Database-acute coronary syndrome) registry (NCVD-ACS) year 2006-2013. Participants 16 517 patients diagnosed of STEMI from 18 hospitals in Malaysia from the year 2006 to 2013. Primary outcome measures In-hospital and 30 day post-discharge mortality. Results CS complicates 10.6% of all STEMIs in this study. They had unfavourable premorbid conditions and poor outcomes. The in-hospital mortality rate was 34.1% which translates into a 7.14 times mortality risk increment compared with STEMI without CS. Intravenous thrombolysis remained as the main urgent reperfusion modality. Percutaneous coronary interventions (PCI) in CS conferred a 40% risk reduction over non-invasive therapy but were only done in 33.6% of cases. Age over 65, diabetes mellitus, hypertension, chronic lung and kidney disease conferred higher risk of mortality. Conclusion Mortality rates of CS complicating STEMI in Malaysia are high. In-hospital PCI confers a 40% mortality risk reduction but the rate of PCI among our patients with CS complicating STEMI is still low. Efforts are being made to increase access to invasive therapy for these patients. © 2019 Author(s) (or their employer(s)). Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
format Article
author Venkatason, Padmaa
Zubairi, Yong Zulina
Wan Ahmad, Wan Azman
Hafidz, Muhammad Imran Abdul
Ismail, Muhammad Dzafir
Hadi, Mohd Firdaus
Zuhdi, Ahmad Syadi Mahmood
author_facet Venkatason, Padmaa
Zubairi, Yong Zulina
Wan Ahmad, Wan Azman
Hafidz, Muhammad Imran Abdul
Ismail, Muhammad Dzafir
Hadi, Mohd Firdaus
Zuhdi, Ahmad Syadi Mahmood
author_sort Venkatason, Padmaa
title In-hospital mortality of cardiogenic shock complicating ST-elevation myocardial infarction in Malaysia: a retrospective analysis of the Malaysian National Cardiovascular Database (NCVD) registry
title_short In-hospital mortality of cardiogenic shock complicating ST-elevation myocardial infarction in Malaysia: a retrospective analysis of the Malaysian National Cardiovascular Database (NCVD) registry
title_full In-hospital mortality of cardiogenic shock complicating ST-elevation myocardial infarction in Malaysia: a retrospective analysis of the Malaysian National Cardiovascular Database (NCVD) registry
title_fullStr In-hospital mortality of cardiogenic shock complicating ST-elevation myocardial infarction in Malaysia: a retrospective analysis of the Malaysian National Cardiovascular Database (NCVD) registry
title_full_unstemmed In-hospital mortality of cardiogenic shock complicating ST-elevation myocardial infarction in Malaysia: a retrospective analysis of the Malaysian National Cardiovascular Database (NCVD) registry
title_sort in-hospital mortality of cardiogenic shock complicating st-elevation myocardial infarction in malaysia: a retrospective analysis of the malaysian national cardiovascular database (ncvd) registry
publisher BMJ Publishing Group
publishDate 2019
url http://eprints.um.edu.my/23201/
https://doi.org/10.1136/bmjopen-2018-025734
_version_ 1654960701405396992
score 13.211869

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