Use of Pulmonary Artery Catheters in Patients with Acute Myocardial Infarction: Results (1)
A total of 371 patients (6.4 percent) received a PAC. The catheter was more frequently used in older age groups (Table 1) with no difference in males and females. Patients developing atrial fibrillation, high-grade atrioventricular block, ventricular tachycardia or ventricular fibrillation received the catheter a little more than twice as often as those without these arrhythmias (12.0 vs 5.7 percent).
Patients with CHF, cardiogenic shock and persistent hypotension received the catheter in 14.6 percent, 26.5 percent and 37.5 percent of cases, respectively. The frequency of the use of the catheter in patients with enzyme levels four or more times the upper limit of normal was increased only for LDH levels (12.2 percent vs 5.9 percent). Patients in “pump failure” (as defined in the Materials and Methods section) received the catheter nine times as frequently as those not in “pump failure” (Table 2), but it should be noted that even in this category, it was used in only 13.7 percent of patients. In-hospital mortality was higher in patients receiving the catheter (53.1 vs 15.2 percent [Fig 1]). The difference in one-year mortality was not statistically significant.
Table 1—Age Distribution of Patients Receiving Pulmonary Artery Catheters
|Age(Years)||No. of Patients||No. (%) Receiving PAC|
Table 2—Patients with Pump Failure Receiving Pulmonary Artery Catheters
|Patients Receiving PAC (%)||Patients not Receiving PAC (%)||Total (%)|
|With pump||319 (13.7)||2,013 (86.3)||2,332 (39.9)|
|Without||52 (1.5)||3,457 (98.5)||3,509 (60.1)|
|Total||371 (6.4)||5,470 (93.6)||5,841 (100.0)|
Figure 1. In-hospital and one-year mortality for patients receiving (FAC+) and those not receiving (PAC—) PAC.