Chimed, Surenjav

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Prognostic Relevance of Intra-aortic Balloon Pump in Patients with Acute Myocardial Infarction Complicated by Cardiogenic Shock: Nationwide Population Study in Taiwan
(Mongolian National University of Medical Sciences, 2016-06-25)
Chimed, Surenjav
;
Khuyag, Batmyagmar
Objectives: Intra-aortic balloon pump (IABP) is the most widely-used form of mechanical hemodynamic support in patients with cardiogenic shock. However, usefulness of IABP in the high-risk patient population is conflicting. We examined whether the patient prognosis in Taiwan forthose treated with IABP has improved in recent years. Methods: We used Taiwan's National Health Insurance Research Database to retrospectively review 3145 (2358 men, 75% of cases) cardiogenic shock patients who were treated with primary percutaneous coronary intervention (PCI) due to acute myocardial infarction (AMI) between 2000 and 2012. The primary outcome was all-cause mortality and secondary outcome was heart failure. Results: A total of 1417 patients who received IABP therapy and 1728 patients who did not receive non-IABP were selected in this study. During the follow-up period, the adjusted hazard ratio for overall mortality was 1.22 (Cl 95%: 1.10-1.35, p<0.0001) and for overall heart failure was 1.24 (Cl 95%: 1.08-1.41, p <0.001). Risk factors for all-cause mortality were previous heart failure, diabetes, chronic kidney disease and hypertension. Conclusion: In this nationwide, population-based, retrospective cohort study in Taiwan, we found that mortality rate and heart failure rate did not decline in cardiogenic shock patients who underwent primary PCI plus IABP therapy.
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Relationship Between Left Ventricular Myocardial Longitudinal Mechanics and In-hospital Heart Failure in Patients With Acute Myocardial Infarction: a Two-dimensional Speckle-tracking Study
(Mongolian National University of Medical Sciences, 2016-11-25)
Khuyag, Batmyagmar
;
Chimed, Surenjav
;
Baldandorj, Amarjargal
;
Zundui, Lkhagvasuren
;
Davaakhuu, Narantuya
Objectives: In-hospital heart failure (HF) during acute myocardial infarction (AMI) is associated with adverse outcome. However, data about the relationship between left ventricular (LV) longitudinal myocardial mechanics and in-hospital HF in patients with AMI is limited. Thus, we aimed to determine the association between speckle-tracking derived global longitudinal strain (GLS) and in-hospital HF. Methods: We selected patients with AMI treated by primary percutaneous coronary intervention (PCI). In-hospital HF was defined by Killip class. Multiple logistic regression analysis was used to reveal the relationship between LV GLS and in-hospital HF. Results: A total of 414 patients (mean age 60 ±13 years, 84% male) were included and in-hospital HF presented in 93 patients (22.5%). LV GLS was significantly impaired in patients with in-hospital HF compared to patients without (-16.1 ±3.7% vs. -11.6 ±3.1%, p<0.001). After adjustment of possible predictors, GLS was independently associated with in-hospital HF (odds ratio 1.32, 95% CI: 1.16-1.50, p<0.001). In-hospital HF presented in 21 patients with preserved left ventricular ejection fraction (LVEF) and GLS was also significantly impaired (-17.7 ±3.2% vs. -12.7 ±2.2%, p<0.001). Separate multiple logistic regression models showed that GLS was still independently associated with in-hospital HF in this group. Conclusion: LV GLS is independently associated with in-hospital HF during AMI. This relationship is still evident for patients with preserved LVEF.

Chimed, Surenjav

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