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Updated: Feb 16, 2026

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

Published on: June 12, 2021

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Optimal course of treatment in acute cardiogenic shock complicating myocardial infarction

Sebastian Nuding1, Karl Werdan1, Roland Prondzinsky2

  • 1a Department of Medicine III , University Hospital Halle (Saale) , Halle (Saale) , Germany.

Expert Review of Cardiovascular Therapy
|January 10, 2018
PubMed

Insights

Cardiogenic shock complicating myocardial infarction has high mortality. Optimal care requires rapid intervention and intensive management, as intra-aortic balloon pumps do not improve survival.

Area of Science:

  • Cardiology
  • Intensive Care Medicine

Background:

  • Cardiogenic shock complicates myocardial infarction in ~5% of patients, carrying a mortality rate of ≥30%.
  • Prognosis is heavily influenced by organ hypoperfusion and subsequent multiple organ dysfunction syndrome.
  • Early diagnosis, monitoring, and treatment are critical for patient outcomes.

Purpose of the Study:

  • To review current diagnostic, monitoring, and treatment strategies for cardiogenic shock complicating myocardial infarction.
  • To evaluate the effectiveness of various therapeutic approaches based on major clinical trials.
  • To provide expert commentary on optimal patient care pathways.

Main Methods:

  • Comprehensive literature search of major clinical trials related to cardiogenic shock in myocardial infarction.
  • Review of diagnostic criteria, hemodynamic monitoring techniques, and therapeutic interventions.
  • Synthesis of recent data and expert opinion on patient management.

Main Results:

  • Primary percutaneous coronary intervention is the most successful therapeutic approach.
  • Intensive care medicine is crucial for preventing multiple organ dysfunction syndrome and reducing mortality.
  • Intra-aortic balloon pump use has not demonstrated a reduction in mortality for these patients.

Conclusions:

  • Optimal management necessitates timely revascularization and advanced intensive care.
  • Avoiding organ hypoperfusion is paramount for improving survival rates.
  • Current evidence suggests intra-aortic balloon pumps are ineffective in reducing mortality in this setting.
Abstract

Keywords:
Acute heart failureIABPIABP-SHOCK II trialIABP-SHOCK trialcardiogenic shockmechanical cardiac supportmultiple organ dysfunction syndromemyocardial infarctionpercutaneous coronary intervention

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