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Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
Published on: June 12, 2021
Emergency revascularization in patients with cardiogenic shock on admission: a report from the SHOCK trial and
Raban V Jeger1, Shannon M Harkness, Krishnan Ramanathan
1Cardiovascular Clinical Research Center, New York University School of Medicine, 530 First Avenue, HCC 1173, New York, NY 10016, USA.
European Heart Journal
|January 21, 2006
Summary
Patients experiencing cardiogenic shock (CS) upon hospital admission have poorer outcomes but equally benefit from emergency revascularization. Rapid access to specialized care is crucial for improving survival in these critical patients.
Area of Science:
- Cardiology
- Critical Care Medicine
- Interventional Cardiology
Background:
- Cardiogenic shock (CS) on admission presents unique challenges compared to delayed CS.
- Patients with left ventricular dysfunction are at high risk for developing CS.
Purpose of the Study:
- To identify clinical characteristics of patients with CS on admission.
- To evaluate the optimal treatment strategy, specifically emergency revascularization, for CS on admission.
Main Methods:
- Analysis of data from the SHould we emergently revascularize Occluded Coronaries in cardiogenic shocK? (SHOCK) trial and registry.
- Comparison of outcomes between patients with CS on admission and those with delayed CS.
- Assessment of the impact of emergency revascularization on in-hospital mortality.
Main Results:
- CS on admission occurred in 26% of directly admitted patients and was associated with poorer hemodynamics and higher mortality.
- In-hospital mortality was significantly higher in CS on admission patients (75% vs. 56%).
- Emergency revascularization reduced in-hospital mortality in both CS on admission and delayed CS groups.
Conclusions:
- CS on admission is an independent predictor of in-hospital mortality.
- Patients with CS on admission benefit from emergency revascularization similarly to delayed CS patients.
- Rapid access to facilities capable of emergency revascularization is essential for improving outcomes in CS on admission.
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