The use of hemodynamics to predict mortality in patients undergoing primary PCI for ST-elevation myocardial infarction.

The use of hemodynamics to predict mortality in patients undergoing primary PCI for ST-elevation myocardial infarction.
Expert Rev Cardiovasc Ther. 2018 Jul 05;:
Authors: Goins AE, Rayson R, Yeung M, Stouffer GA
Abstract
INTRODUCTION: Challenges remain in predicting mortality and severe myocardial dysfunction in patients undergoing primary percutaneous coronary intervention (PPCI) for ST elevation myocardial infarction (STEMI). Areas covered: Cardiogenic shock is associated with a high mortality rate. Less well characterized are patients who are not in cardiogenic shock but will die from pump failure as a result of a STEMI. There is a long history of using hemodynamics to risk stratify patients with acute MI with the Killip class being shown to provide prognostic information in the pre-reperfusion, thrombolytic and PPCI eras. Recent studies have identified low systolic blood pressure (SBP), elevated heart rate, elevated left ventricular end diastolic pressure (LVEDP) and low SBP/LVEDP ratio as hemodynamic parameters associated with early mortality in patients undergoing PPCI. Although infrequently used, prognostic information can be obtained from right heart catheterization in the setting of STEMI with the best studied parameters being cardiac power, pulmonary capillary wedge pressure (PCWP), cardiac output, right atrial pressure/PCWP ratio and pulmonary artery pulsatility index. Expert commentary: Hemodynamic parameters measured at ...

Source: Expert Review of Cardiovascular Therapy - July 6, 2018 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research