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Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
06:10

Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock

Published on: June 12, 2021

Percutaneous coronary intervention in cardiogenic shock complicating acute ST-elevation myocardial infarction-a

Vijayakumar Subban1, Anand Gnanaraj, Balashankar Gomathi

  • 1Department of Cardiology, Madras Medical Mission, Tamilnadu, India.

Indian Heart Journal
|May 11, 2012
PubMed

Insights

Early revascularization improves survival in acute myocardial infarction (AMI) with cardiogenic shock (CS). Achieving TIMI 3 flow in the infarct-related artery is key for survival after percutaneous coronary intervention (PCI).

Area of Science:

  • Cardiology
  • Interventional Cardiology

Background:

  • Mortality in acute myocardial infarction (AMI) with cardiogenic shock (CS) remains high (70-80%) despite pharmacological treatments.
  • Early revascularization is crucial for improving survival in AMI patients experiencing CS.

Purpose of the Study:

  • To assess predictors of mid-term outcomes in ST-segment elevation myocardial infarction (STEMI) patients with CS.
  • Evaluate survival rates after percutaneous coronary intervention (PCI) in STEMI with CS.

Main Methods:

  • Analysis of 41 patients undergoing primary or rescue PCI for CS.
  • Comparison of baseline, angiographic, and PCI data with 30-day and 1-year survival.

Main Results:

  • Higher rates of transfer admissions and cardiopulmonary resuscitations were observed in non-survivors.
  • Pre-procedure Thrombolysis In Myocardial Infarction (TIMI) flow grade 3 in the infarct-related artery (IRA) significantly correlated with better survival (P=0.0005).
  • Successful PCI was achieved in 48.8% of patients, with significantly better short-term survival compared to failed PCI (80% vs 9.6%). 30-day mortality was 56.1%.

Conclusions:

  • Mortality remains high in STEMI with CS, even after PCI.
  • Achieving IRA patency with TIMI 3 flow is the primary determinant of survival.
  • Patients discharged from the hospital after PCI demonstrate good survival and functional status.
Abstract

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