ABS20191028_0012
Hemodynamic Support and Cardiogenic Shock
Lactate Before IABP Out and Fibrinogen are Related to Mortality in Patients with STEMI Complicated by Cardiogenic Shock
Changxi Chen1, Zhou Hao1
The First Affiliated Hospital of Wenzhou Medical College, China1
Background:
Cardiogenic shock (CS), as a complication of acute myocardial infarction, continues to beassociated with a poor prognosis. Routine IABP counterpulsation cannot be recommended according to European Society of Cardiology guidelines. The benefit of IABP counterpulsation is still subject to debate, and a considerable gap exists between its guidelines and clinical practice. A retrospective analysis was conducted from a single registered database.
Methods:
Atotal of 92 consecutive patients with STEMI complicated by CS treated with IABP were enrolled. The end points were all-cause mortality. The mean follow-up time was 12 months, and death events occurred in 48 cases. The patients were grouped into 2 groups according to the patients who survived or did not survive to follow-up. 
Results:
Ina multivariate logistic model, univariate and multivariate logistic analysesrevealed that mortality was associated with the lactate before IABP out (hazardratio = 2.15; 95% CI, 1.31-3.53; P= 0.002) and fibrinogen levels (hazard ratio= 1.94; 95% CI, 1.16-3.25; P = 0.012). The ROC curve for the lactate beforeIABP out area under the curve was 0.77 (95% CI, 0.67 to 0.85; P < 0.001).Using a lactate before IABP out value of ¡Ã 4.3 mmol /L, the model had a sensitivity of 58.33% and a specificity of 100.00% for predicting mortality in patients with STEMI complicated by CS treated with IABP. The ROC curve for the lactate before IABP out and fibrinogen area under the curve was 0.85 (95% CI,0.77 to 0.93; P <0.001).
Conclusion:
 In conclusion, an increase in the lactate before IABP out and fibrinogen are independently correlated with death risks in patients with STEMI complicated by CS with IABP support.
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