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Treatment options for acute myocardial infarction complicated by cardiogenic shock
H L Dauerman1, R J Goldberg, J M Gore
1Cardiovascular Division, University of Massachusetts, Memorial Medical Center, 55 Lake Avenue North, Worcester, MA 01655, USA.
Insights
Interventional treatments, particularly acute infarct angioplasty, have significantly improved survival rates for patients experiencing acute myocardial infarction with cardiogenic shock in recent years.
Area of Science:
- Cardiology
- Interventional Cardiology
- Critical Care Medicine
Background:
- Acute myocardial infarction complicated by cardiogenic shock historically has a poor prognosis.
- Prior to the 1990s, medical and supportive management, including thrombolytic therapy, showed limited impact on outcomes.
Purpose of the Study:
- To evaluate the impact of evolving treatment strategies on hospital survival for acute myocardial infarction with cardiogenic shock.
Main Methods:
- Review of treatment approaches for acute myocardial infarction complicated by cardiogenic shock.
- Comparison of outcomes between medical/supportive care and interventional strategies.
Main Results:
- Hospital survival for acute myocardial infarction with cardiogenic shock has improved in recent years.
- The shift towards interventional approaches, primarily acute infarct angioplasty, correlates with improved prognosis.
Conclusions:
- Interventional cardiology has transformed the management of acute myocardial infarction complicated by cardiogenic shock.
- Acute infarct angioplasty is associated with better outcomes in this high-risk patient population.
Abstract:
Hospital survival of patients with acute myocardial infarction complicated by cardiogenic shock has improved during recent years. Before the 1990s, emphasis on a medical and supportive approach to treatment of these high-risk patients (including thrombolytic therapy) was not clearly associated with improving outcomes. However, in the past decade, the interventional approach to treatment of acute myocardial infarction complicated by cardiogenic shock (mainly acute infarct angioplasty) has led to an improving prognosis across a broad spectrum of patients with cardiogenic shock.