Related Experiment Video
Updated: Nov 5, 2025
Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
Published on: June 12, 2021
Revascularization Strategies in Patients with Acute Myocardial Infarction and Cardiogenic Shock: Results from the
Sofia Alegria1, Ana Marques1, Ana Catarina Gomes1
1Hospital Garcia de Orta EPE, Almada - Portugal.
Insights
For patients with acute myocardial infarction, cardiogenic shock, and multivessel disease, complete versus incomplete revascularization during hospitalization showed no significant difference in in-hospital death or recurrent myocardial infarction. Further research is needed to optimize treatment strategies.
Area of Science:
- Cardiology
- Interventional Cardiology
- Acute Coronary Syndromes
Background:
- Management of acute myocardial infarction (MI) with cardiogenic shock (CS) and multivessel disease (MVD) remains complex.
- Optimal revascularization strategies for non-culprit arteries in this high-risk population are not fully established.
Purpose of the Study:
- To characterize patients with MI, CS, and MVD in the Portuguese Registry on Acute Coronary Syndromes (ProACS).
- To compare different revascularization strategies in this patient cohort.
- To identify predictors of in-hospital mortality.
Main Methods:
- Retrospective observational study of 127 patients with MI, CS, and MVD from the ProACS registry (2010-2018).
- Comparison of complete revascularization during the index procedure versus complete or incomplete revascularization during index hospitalization.
- Primary endpoint: composite of in-hospital death or MI.
Main Results:
- No significant difference in the primary endpoint (in-hospital death or MI) between complete (47.8%) and incomplete (37.5%) revascularization strategies (p=0.359).
- Similar rates of in-hospital death, recurrent MI, stroke, and major bleeding across groups.
- Predictors of in-hospital death included left ventricle systolic dysfunction (OR 16.8), right bundle branch block (OR 7.6), and anemia (OR 5.2).
Conclusions:
- In patients with MI, CS, and MVD, complete versus incomplete revascularization during index hospitalization did not significantly impact in-hospital death or recurrent MI.
- Left ventricle systolic dysfunction, right bundle branch block, and anemia are significant predictors of in-hospital mortality in this population.
Background:
In patients with acute myocardial infarction (MI), cardiogenic shock (CS), and multivessel disease (MVD) questions remain unanswered when it comes to intervention on non-culprit arteries.
Objective:
This article aims to 1) characterize patients with MI, CS and MVD included in the Portuguese Registry on Acute Coronary Syndromes (ProACS); 2) compare different revascularization strategies in the sample; 3) identify predictors of in-hospital mortality among these patients.
Methods:
Observational retrospective study of patients with MI, CS and MVD included in the ProACS between 2010 and 2018. Two revascularization strategies were compared: complete during the index procedure (group 1); and complete or incomplete during the index hospitalization (groups 2-3). The primary endpoint was a composite of in-hospital death or MI. Statistical significance was defined by a p-value <0.05.
Results:
We identified 127 patients with MI, CS, and MVD (18.1% in group 1, and 81.9% in groups 2-3), with a mean age of 7012 years, and 92.9% of the sample being diagnosed with ST-segment elevation MI (STEMI). The primary endpoint occurred in 47.8% of the patients in group 1 and 37.5% in group 2-3 (p = 0.359). The rates of in-hospital death, recurrent MI, stroke, and major bleeding were also similar. The predictors of in-hospital death in this sample were the presence of left ventricle systolic dysfunction on admission (OR 16.8), right bundle branch block (OR 7.6), and anemia (OR 5.2) (p ≤ 0.02 for both).
Conclusions:
Among patients with MI, CS, and MVD included in the ProACS, there was no significant difference between complete and incomplete revascularization during the index hospitalization regarding the occurrence of in-hospital death or MI. (Arq Bras Cardiol. 2021; 116(5):867-876).
More Related Videos
05:41Left Anterior Descending Coronary Artery Ligation for Ischemia-Reperfusion Research: Model Improvement via Technical Modifications and Quality Control
Published on: December 16, 2022
14:35Post-Myocardial Infarction Heart Failure in Closed-chest Coronary Occlusion/Reperfusion Model in Göttingen Minipigs and Landrace Pigs
Published on: April 17, 2021
Related Concept Videos
01:28Acute Coronary Syndrome IV: Interprofessional Care
01:25Cardiopulmonary Resuscitation IV: Pharmacological Management
01:27Coronary Artery Disease V: Interprofessional Care
01:30Acute Coronary Syndrome I: Introduction
01:26Acute Coronary Syndrome V: Nursing Management
01:30Acute Coronary Syndrome III: Diagnostic Studies