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While deriving the Doppler formula for the observed frequency of a sound wave, it is assumed that the speed of sound in the medium is greater than the source's speed through it. When this condition is breached, a shock wave occurs.
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Updated: Feb 6, 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

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One-Year Outcomes after PCI Strategies in Cardiogenic Shock.

Holger Thiele1, Ibrahim Akin1, Marcus Sandri1

  • 1From Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig (H.T., M.S., A.J., S.D.), Universitätsmedizin Mannheim, Mannheim (I.A.), University Heart Center Lübeck, Lübeck (S.W.-T., R.M.-S., G.F., I.E.), German Center for Cardiovascular Research (I.A., S.W.-T., R.M.-S., G.F., I.E., U.L., C.S., A.J., S.B.F., S.D.) and Universitätsklinikum Charité, Campus Benjamin Franklin (U.L., C.S.), Berlin, Universitätsklinikum Würzburg, Würzburg (P.N.), Klinikum der Eberhard-Karls-Universität Tübingen, Tübingen (T. Geisler), Klinikum Links der Weser, Bremen (A.F.), Helios Klinik Erfurt, Erfurt (H.L.), Ernst-Moritz-Arndt-Universität, Greifswald (S.B.F.), Universitäres Herzzentrum Regensburg, Regensburg (L.S.M.), and Institut für Herzinfarktforschung (S. Schneider, U.Z.) and Klinikum Ludwigshafen (U.Z.), Ludwigshafen - all in Germany; Academic Medical Center, Amsterdam (J.J.P.); University Medical Center Ljubljana, Ljubljana, Slovenia (M.N., T. Goslar); Institute of Cardiology, Warsaw, Poland (J.S.); Golden Jubilee National Hospital, Glasgow, United Kingdom (K.O.); Vilnius University Hospital Santaros Klinikos and Faculty of Medicine, Vilnius University, Vilnius, Lithuania (P.S.); Sorbonne Université Paris 6, ACTION Study Group, Centre Hospitalier Universitaire Pitié-Salpêtrière (G.M., O.B.), and Applied Research, Technology Transfer, Industrial Collaboration, Société par Actions Simplifiée (P.T.), Paris; Wilhelminenpital, Department of Cardiology, and Sigmund Freud University, Medical School, Vienna (K.H.); the Department of Cardiology, Inselspital Bern, University of Bern, Bern, Switzerland (S.W., L.H.); Manzoni Hospital, Lecco, Italy (S. Savonitto); and Universitair Ziekenhuis Antwerp, Antwerp, Belgium (C.V.).

The New England Journal of Medicine
|August 28, 2018
PubMed
Summary
This summary is machine-generated.

Percutaneous coronary intervention (PCI) of only the culprit lesion in acute myocardial infarction with cardiogenic shock patients significantly reduced the risk of death or renal replacement therapy at 30 days. One-year mortality showed no significant difference between culprit-lesion-only PCI and immediate multivessel PCI.

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Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Acute Myocardial Infarction Management

Background:

  • Patients with acute myocardial infarction (AMI), cardiogenic shock, and multivessel coronary artery disease (CAD) face high risks.
  • Previous findings indicated a lower 30-day risk of death or renal replacement therapy with culprit-lesion-only PCI compared to immediate multivessel PCI.

Purpose of the Study:

  • To evaluate the 1-year clinical outcomes in patients with AMI and cardiogenic shock treated with either culprit-lesion-only PCI or immediate multivessel PCI.
  • To compare the long-term efficacy and safety of these two revascularization strategies.

Main Methods:

  • A randomized trial involving 706 patients with AMI and cardiogenic shock.
  • Patients were assigned to either culprit-lesion-only PCI or immediate multivessel PCI.
  • Clinical outcomes, including mortality, recurrent myocardial infarction, revascularization, and heart failure hospitalizations, were assessed at 1 year.

Main Results:

  • At 1 year, all-cause mortality occurred in 50.0% of the culprit-lesion-only PCI group versus 56.9% in the multivessel PCI group (relative risk, 0.88; 95% CI, 0.76 to 1.01).
  • Recurrent infarction rates were similar (1.7% vs. 2.1%).
  • Repeat revascularization (32.3% vs. 9.4%) and heart failure rehospitalization (5.2% vs. 1.2%) were significantly higher with culprit-lesion-only PCI.

Conclusions:

  • Culprit-lesion-only PCI demonstrated a lower risk of death or renal replacement therapy at 30 days in patients with AMI and cardiogenic shock.
  • While 1-year mortality did not differ significantly, the increased rates of repeat revascularization and heart failure hospitalizations with culprit-lesion-only PCI warrant consideration.