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Updated: Apr 27, 2026

Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
Published on: June 12, 2021
[Treatment of cardiogenic shock complicating acute myocardial infarction]
S Blazek1, K Fengler, T Stiermaier
1Klinik für Innere Medizin/Kardiologie, Universität Leipzig - Herzzentrum, Strümpellstr. 39, 04289, Leipzig, Deutschland.
Insights
Outcomes for acute myocardial infarction patients with cardiogenic shock remain poor despite advances. Further research is needed on medical therapies and mechanical support timing to improve survival in these critical cases.
Area of Science:
- Cardiology
- Critical Care Medicine
Context:
- Acute myocardial infarction (AMI) mortality has decreased.
- Cardiogenic shock (CS) complicating AMI still has devastating outcomes.
- Current therapies for CS have limitations.
Purpose:
- To review the current state of managing cardiogenic shock complicating AMI.
- To highlight the limitations of existing medical and mechanical support.
- To suggest future research directions.
Summary:
- Medical therapies for CS often cause side effects or provide insufficient hemodynamic support.
- Mechanical circulatory support has not consistently improved survival in CS.
- Emerging evidence suggests potential survival benefits in refractory CS with mechanical support.
Impact:
- Highlights the urgent need for improved therapeutic strategies for CS.
- Emphasizes the importance of evaluating novel medical treatments.
- Underscores the necessity of optimizing mechanical support selection and timing.
Abstract:
While the mortality rate of acute myocardial infarction has decreased drastically in the last decades, the outcome of patients with cardiogenic shock complicating acute myocardial infarction is still devastating. The effectiveness of supportive medicinal therapy of cardiogenic shock is often limited by undesired side effects (e.g. arrhythmia and increased myocardial oxygen consumption) or inadequate hemodynamic support. Mechanical circulatory support in cardiogenic shock failed to show beneficial effects on short-term and long-term survival; however, there are hints for a survival benefit in therapy refractory cardiogenic shock. Therefore, future trials need to evaluate further medicinal treatment options and also the best type of mechanical support as well as the optimal time of initiation to improve the success of therapeutic management.
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