Predictive value of the baseline electrocardiogram ST-segment
pattern in cardiogenic shock: Results from the CardShock Study

J 2018

Predictive value of the baseline electrocardiogram ST-segment pattern in cardiogenic shock: Results from the CardShock Study

JAVANAINEN, Tuija, Heli TOLPPANEN, Johan LASSUS, Markku S. NIEMINEN, Alessandro SIONIS et. al.

Basic information

Original name

Predictive value of the baseline electrocardiogram ST-segment pattern in cardiogenic shock: Results from the CardShock Study

Authors

JAVANAINEN, Tuija (246 Finland, guarantor), Heli TOLPPANEN (246 Finland), Johan LASSUS (246 Finland), Markku S. NIEMINEN (246 Finland), Alessandro SIONIS (724 Spain), Jindřich ŠPINAR (203 Czech Republic, belonging to the institution), Jose SILVA-CARDOSO (620 Portugal), Matias LINDHOLM (208 Denmark), Marek BANASZEWSKI (616 Poland), Veli-Pekka HARJOLA (246 Finland) and Raija JURKKO (246 Finland)

Edition

ANNALS OF NONINVASIVE ELECTROCARDIOLOGY, HOBOKEN, WILEY, 2018, 1082-720X

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30201 Cardiac and Cardiovascular systems

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

Impact factor

Impact factor: 1.235

RIV identification code

RIV/00216224:14110/18:00104203

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1111/anec.12561

UT WoS

000443676200010

Keywords in English

acute coronary syndrome; acute heart failure; cardiogenic shock; electrocardiography; prognosis

Abstract

V originále

BackgroundThe most common aetiology of cardiogenic shock (CS) is acute coronary syndrome (ACS), but even up to 20%-50% of CS is caused by other disorders. ST-segment deviations in the electrocardiogram (ECG) have been investigated in patients with ACS-related CS, but not in those with other CS aetiologies. We set out to explore the prevalence of different ST-segment patterns and their associations with the CS aetiology, clinical findings and 90-day mortality. MethodsWe analysed the baseline ECG of 196 patients who were included in a multinational prospective study of CS. The patients were divided into 3 groups: (a) ST-segment elevation (STE). (b) ST-segment depression (STDEP). (c) No ST-segment deviation or ST-segment impossible to analyse (NSTD). A subgroup analysis of the ACS patients was conducted. ResultsST-segment deviations were present in 80% of the patients: 52% had STE and 29% had STDEP. STE was associated with the ACS aetiology, but one-fourth of the STDEP patients had aetiology other than ACS. The overall 90-day mortality was 41%: in STE 47%, STDEP 36% and NSTD 33%. In the multivariate mortality analysis, only STE predicted mortality (HR 1.74, CI95 1.07-2.84). In the ACS subgroup, the patients were equally effectively revascularized, and no differences in the survival were noted between the study groups. ConclusionST-segment elevation is associated with the ACS aetiology and high mortality in the unselected CS population. If STE is not present, other aetiologies must be considered. When effectively revascularized, the prognosis is similar regardless of the ST-segment pattern in ACS-related CS.

Citovat

JAVANAINEN, Tuija, Heli TOLPPANEN, Johan LASSUS, Markku S. NIEMINEN, Alessandro SIONIS, Jindřich ŠPINAR, Jose SILVA-CARDOSO, Matias LINDHOLM, Marek BANASZEWSKI, Veli-Pekka HARJOLA and Raija JURKKO. Predictive value of the baseline electrocardiogram ST-segment pattern in cardiogenic shock: Results from the CardShock Study. ANNALS OF NONINVASIVE ELECTROCARDIOLOGY. HOBOKEN: WILEY, 2018, vol. 23, No 5, p. 1-9. ISSN 1082-720X. Available from: https://dx.doi.org/10.1111/anec.12561.

@article{1455636,
   author = {Javanainen, Tuija and Tolppanen, Heli and Lassus, Johan and Nieminen, Markku S. and Sionis, Alessandro and Špinar, Jindřich and SilvaandCardoso, Jose and Lindholm, Matias and Banaszewski, Marek and Harjola, VeliandPekka and Jurkko, Raija},
   article_location = {HOBOKEN},
   article_number = {5},
   doi = {http://dx.doi.org/10.1111/anec.12561},
   keywords = {acute coronary syndrome; acute heart failure; cardiogenic shock; electrocardiography; prognosis},
   language = {eng},
   issn = {1082-720X},
   journal = {ANNALS OF NONINVASIVE ELECTROCARDIOLOGY},
   title = {Predictive value of the baseline electrocardiogram ST-segment pattern in cardiogenic shock: Results from the CardShock Study},
   volume = {23},
   year = {2018}
}

TY  - JOUR
ID  - 1455636
AU  - Javanainen, Tuija - Tolppanen, Heli - Lassus, Johan - Nieminen, Markku S. - Sionis, Alessandro - Špinar, Jindřich - Silva-Cardoso, Jose - Lindholm, Matias - Banaszewski, Marek - Harjola, Veli-Pekka - Jurkko, Raija
PY  - 2018
TI  - Predictive value of the baseline electrocardiogram ST-segment pattern in cardiogenic shock: Results from the CardShock Study
JF  - ANNALS OF NONINVASIVE ELECTROCARDIOLOGY
VL  - 23
IS  - 5
SP  - 1-9
EP  - 1-9
PB  - WILEY
SN  - 1082720X
KW  - acute coronary syndrome
KW  - acute heart failure
KW  - cardiogenic shock
KW  - electrocardiography
KW  - prognosis
N2  - BackgroundThe most common aetiology of cardiogenic shock (CS) is acute coronary syndrome (ACS), but even up to 20%-50% of CS is caused by other disorders. ST-segment deviations in the electrocardiogram (ECG) have been investigated in patients with ACS-related CS, but not in those with other CS aetiologies. We set out to explore the prevalence of different ST-segment patterns and their associations with the CS aetiology, clinical findings and 90-day mortality. MethodsWe analysed the baseline ECG of 196 patients who were included in a multinational prospective study of CS. The patients were divided into 3 groups: (a) ST-segment elevation (STE). (b) ST-segment depression (STDEP). (c) No ST-segment deviation or ST-segment impossible to analyse (NSTD). A subgroup analysis of the ACS patients was conducted. ResultsST-segment deviations were present in 80% of the patients: 52% had STE and 29% had STDEP. STE was associated with the ACS aetiology, but one-fourth of the STDEP patients had aetiology other than ACS. The overall 90-day mortality was 41%: in STE 47%, STDEP 36% and NSTD 33%. In the multivariate mortality analysis, only STE predicted mortality (HR 1.74, CI95 1.07-2.84). In the ACS subgroup, the patients were equally effectively revascularized, and no differences in the survival were noted between the study groups. ConclusionST-segment elevation is associated with the ACS aetiology and high mortality in the unselected CS population. If STE is not present, other aetiologies must be considered. When effectively revascularized, the prognosis is similar regardless of the ST-segment pattern in ACS-related CS.
ER  -

JAVANAINEN, Tuija, Heli TOLPPANEN, Johan LASSUS, Markku S. NIEMINEN, Alessandro SIONIS, Jindřich ŠPINAR, Jose SILVA-CARDOSO, Matias LINDHOLM, Marek BANASZEWSKI, Veli-Pekka HARJOLA and Raija JURKKO. Predictive value of the baseline electrocardiogram ST-segment pattern in cardiogenic shock: Results from the CardShock Study. \textit{ANNALS OF NONINVASIVE ELECTROCARDIOLOGY}. HOBOKEN: WILEY, 2018, vol.~23, No~5, p.~1-9. ISSN~1082-720X. Available from: https://dx.doi.org/10.1111/anec.12561.

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