Timing of mechanical ventilation and its association with in-hospital outcomes in patients with cardiogenic shock following ST-elevation myocardial infarction: a multicentre observational study
Objective To evaluate the association between the timing of invasive mechanical ventilation (MV) initiation and clinical outcomes in patients with cardiogenic shock (CS) secondary to ST-elevation myocardial infarction (STEMI).Design Retrospective analysis of a multicentre registry.Setting Data were...
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BMJ Publishing Group
2025-06-01
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| author | Waleed AlHarbi Mohammed Qutub Prashanth Panduranga Jassim Al Suwaidi Wael Al Mahmeed Hassan Khan Sultan Alobaikan Abdullah Alenezi Mohammed AlShehri Abdulrahman Arabi Amin Daoulah Awad Abdulrazaq AlQahtani Zubair Shahid Ahmed Jamjoom Ahmed Elmahrouk Abeer Said Mohamed Al Rawahi Gladsy Selva Livingston Ala’a Al-deen Tayseer Mousa Hatem Aloui Mubarak Aldossari Nooraldaem Yousif Husam Noor Rajesh Rajan Amr A Arafat Omar Kanbr Alsayed Almarghany Mokhtar Kahin Abdulwali Abohasan Faisal Al Nasser Badr Alzahrani Alaa Aldossari Taher Hassan Mohammed Ali Balghith Khalid Alshali Amir Lotfi |
| author_facet | Waleed AlHarbi Mohammed Qutub Prashanth Panduranga Jassim Al Suwaidi Wael Al Mahmeed Hassan Khan Sultan Alobaikan Abdullah Alenezi Mohammed AlShehri Abdulrahman Arabi Amin Daoulah Awad Abdulrazaq AlQahtani Zubair Shahid Ahmed Jamjoom Ahmed Elmahrouk Abeer Said Mohamed Al Rawahi Gladsy Selva Livingston Ala’a Al-deen Tayseer Mousa Hatem Aloui Mubarak Aldossari Nooraldaem Yousif Husam Noor Rajesh Rajan Amr A Arafat Omar Kanbr Alsayed Almarghany Mokhtar Kahin Abdulwali Abohasan Faisal Al Nasser Badr Alzahrani Alaa Aldossari Taher Hassan Mohammed Ali Balghith Khalid Alshali Amir Lotfi |
| author_sort | Waleed AlHarbi |
| collection | DOAJ |
| description | Objective To evaluate the association between the timing of invasive mechanical ventilation (MV) initiation and clinical outcomes in patients with cardiogenic shock (CS) secondary to ST-elevation myocardial infarction (STEMI).Design Retrospective analysis of a multicentre registry.Setting Data were obtained from the Gulf-Cardiogenic Shock registry, which includes hospitals across six countries in the Middle East.Participants 1117 patients diagnosed with STEMI and CS. Of these, 672 (60%) required MV and were included in this analysis.Primary and secondary outcome measures The primary outcome was in-hospital mortality. Secondary outcomes included comparisons of baseline characteristics, Society of Coronary Angiogram and Intervention (SCAI) shock stage, and clinical parameters among groups based on time to MV.Results Participants were categorised by time from shock diagnosis to MV: early (≤15 min), intermediate (30 min) and late (≥60 min). Median times were 15 min (IQR 10–20), 30 min (IQR 25–35) and 60 min (IQR 45–70), respectively. Baseline characteristics were comparable across groups. Increased delay in MV was associated with a higher mortality risk during the first 60 min post-diagnosis, beyond which the risk plateaued. Delayed MV was an independent predictor of in-hospital mortality (OR 2.14, 95% CI 1.36 to 3.38, p<0.001).Conclusions Early initiation of MV in patients with STEMI complicated by CS was associated with lower in-hospital mortality. These findings highlight the importance of timely respiratory support, warranting further investigation in prospective or randomised controlled studies. |
| format | Article |
| id | doaj-art-09005eeec359408b8e9cf1a26175c179 |
| institution | DOAJ |
| issn | 2044-6055 |
| language | English |
| publishDate | 2025-06-01 |
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| spelling | doaj-art-09005eeec359408b8e9cf1a26175c1792025-08-20T03:22:22ZengBMJ Publishing GroupBMJ Open2044-60552025-06-0115610.1136/bmjopen-2025-099208Timing of mechanical ventilation and its association with in-hospital outcomes in patients with cardiogenic shock following ST-elevation myocardial infarction: a multicentre observational studyWaleed AlHarbi0Mohammed Qutub1Prashanth Panduranga2Jassim Al Suwaidi3Wael Al Mahmeed4Hassan Khan5Sultan Alobaikan6Abdullah Alenezi7Mohammed AlShehri8Abdulrahman Arabi9Amin Daoulah10Awad Abdulrazaq AlQahtani11Zubair Shahid12Ahmed Jamjoom13Ahmed Elmahrouk14Abeer Said Mohamed Al Rawahi15Gladsy Selva Livingston16Ala’a Al-deen Tayseer Mousa17Hatem Aloui18Mubarak Aldossari19Nooraldaem Yousif20Husam Noor21Rajesh Rajan22Amr A Arafat23Omar Kanbr24Alsayed Almarghany25Mokhtar Kahin26Abdulwali Abohasan27Faisal Al Nasser28Badr Alzahrani29Alaa Aldossari30Taher Hassan31Mohammed Ali Balghith32Khalid Alshali33Amir Lotfi34Chest Diseases Hospital, Sabah Medical Area, Shuwaikh, KuwaitDepartment of Medicine, Cardiology Center of Excellence, King Abdulaziz University, Jeddah, Saudi ArabiaDepartment of Cardiology, Royal Hospital, Ottawa, Ontario, CanadaHamad Medical Corporation, Doha, QatarHeart & Vascular Institute, Cleveland Clinic, Abu Dhabi, UAEHeart & Vascular Institute, Cleveland Clinic, Abu Dhabi, UAEKing Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Saudi ArabiaChest Diseases Hospital, Sabah Medical Area, Shuwaikh, KuwaitDepartment of Cardiology, Prince Khaled Bin Sultan Cardiac Center, Khamis Mushait, Saudi ArabiaHamad Medical Corporation, Doha, QatarDepartment of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Jeddah, Saudi ArabiaHamad Medical Corporation, Doha, QatarHamad Medical Corporation, Doha, QatarDepartment of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Jeddah, Saudi ArabiaDepartment of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Jeddah, Saudi ArabiaDepartment of Cardiology, Royal Hospital, Ottawa, Ontario, CanadaDepartment of Cardiology, Royal Hospital, Ottawa, Ontario, CanadaHamad Medical Corporation, Doha, QatarHeart Health Center, King Saud Medical City, Jeddah, Saudi ArabiaHeart Health Center, King Saud Medical City, Jeddah, Saudi ArabiaMohammed Bin Khalifa Specialist Cardiac Center, Awali, BahrainMohammed Bin Khalifa Specialist Cardiac Center, Awali, BahrainDepartment of Cardiology, Al Amiri Hospital, Kuwait City, KuwaitDepartment of Cardiothoracic Surgery, Tanta University, Tanta, EgyptElrazi University, Khartoum, Sudanl-Azhar University, Cairo, EgyptInternational Medical Center, Jeddah, Saudi ArabiaCentral Hospital Hafr Albatin, Hafr Abatin, Saudi ArabiaMadinah Cardiac Center, Madinah, Saudi ArabiaAdult Cardiology Department, Prince Sultan Cardiac Center, Riyadh, Saudi ArabiaKing Salman Heart Center, King Fahad Medical City, Riyadh, Saudi ArabiaBugshan General Hospital, Jeddah, Saudi ArabiaKing Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi ArabiaKing Abdulaziz University, Jeddah, Saudi ArabiaUniversity of Massachusetts Chan Medical School - Baystate Campus, Springfield, Massachusetts, USAObjective To evaluate the association between the timing of invasive mechanical ventilation (MV) initiation and clinical outcomes in patients with cardiogenic shock (CS) secondary to ST-elevation myocardial infarction (STEMI).Design Retrospective analysis of a multicentre registry.Setting Data were obtained from the Gulf-Cardiogenic Shock registry, which includes hospitals across six countries in the Middle East.Participants 1117 patients diagnosed with STEMI and CS. Of these, 672 (60%) required MV and were included in this analysis.Primary and secondary outcome measures The primary outcome was in-hospital mortality. Secondary outcomes included comparisons of baseline characteristics, Society of Coronary Angiogram and Intervention (SCAI) shock stage, and clinical parameters among groups based on time to MV.Results Participants were categorised by time from shock diagnosis to MV: early (≤15 min), intermediate (30 min) and late (≥60 min). Median times were 15 min (IQR 10–20), 30 min (IQR 25–35) and 60 min (IQR 45–70), respectively. Baseline characteristics were comparable across groups. Increased delay in MV was associated with a higher mortality risk during the first 60 min post-diagnosis, beyond which the risk plateaued. Delayed MV was an independent predictor of in-hospital mortality (OR 2.14, 95% CI 1.36 to 3.38, p<0.001).Conclusions Early initiation of MV in patients with STEMI complicated by CS was associated with lower in-hospital mortality. These findings highlight the importance of timely respiratory support, warranting further investigation in prospective or randomised controlled studies.https://bmjopen.bmj.com/content/15/6/e099208.full |
| spellingShingle | Waleed AlHarbi Mohammed Qutub Prashanth Panduranga Jassim Al Suwaidi Wael Al Mahmeed Hassan Khan Sultan Alobaikan Abdullah Alenezi Mohammed AlShehri Abdulrahman Arabi Amin Daoulah Awad Abdulrazaq AlQahtani Zubair Shahid Ahmed Jamjoom Ahmed Elmahrouk Abeer Said Mohamed Al Rawahi Gladsy Selva Livingston Ala’a Al-deen Tayseer Mousa Hatem Aloui Mubarak Aldossari Nooraldaem Yousif Husam Noor Rajesh Rajan Amr A Arafat Omar Kanbr Alsayed Almarghany Mokhtar Kahin Abdulwali Abohasan Faisal Al Nasser Badr Alzahrani Alaa Aldossari Taher Hassan Mohammed Ali Balghith Khalid Alshali Amir Lotfi Timing of mechanical ventilation and its association with in-hospital outcomes in patients with cardiogenic shock following ST-elevation myocardial infarction: a multicentre observational study BMJ Open |
| title | Timing of mechanical ventilation and its association with in-hospital outcomes in patients with cardiogenic shock following ST-elevation myocardial infarction: a multicentre observational study |
| title_full | Timing of mechanical ventilation and its association with in-hospital outcomes in patients with cardiogenic shock following ST-elevation myocardial infarction: a multicentre observational study |
| title_fullStr | Timing of mechanical ventilation and its association with in-hospital outcomes in patients with cardiogenic shock following ST-elevation myocardial infarction: a multicentre observational study |
| title_full_unstemmed | Timing of mechanical ventilation and its association with in-hospital outcomes in patients with cardiogenic shock following ST-elevation myocardial infarction: a multicentre observational study |
| title_short | Timing of mechanical ventilation and its association with in-hospital outcomes in patients with cardiogenic shock following ST-elevation myocardial infarction: a multicentre observational study |
| title_sort | timing of mechanical ventilation and its association with in hospital outcomes in patients with cardiogenic shock following st elevation myocardial infarction a multicentre observational study |
| url | https://bmjopen.bmj.com/content/15/6/e099208.full |
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