[Myocardial revascularization in patients with acute myocardial infarction complicated with shock]

In the last 20 years, the acute myocardial infarction 30 day mortality rate has been reduced significantly, following pharmacological and mechanical reperfusion therapies. Nevertheless, cardiogenic shock complicating acute myocardial infarction remains the leading cause of death because of the extensive ventricular function damage non. Randomized studies were over optimistic reporting markedly lower mortality rates among patients who had undergone revascularization for shock. Further randomised studies showed that the angiographic improvement is not always followed by a significant mortality reduction. However, angiographic study and revascularisation is the treatment of choice. In addition to an early reperfusion, new pharmacological and/or genetic ways to improve the ventricular function have to be found.