{"article_title":"Cardiogenic Shock After Acute Myocardial Infarction: A Review.","author":"\"Samsky, Marc D , Morrow, David A , Proudfoot, Alastair G , Hochman, Judith S , Thiele, Holger , Rao, Sunil V\"","journal_title":"JAMA","issn":"1538-3598 ; Electronic","isbn":"","publication_date":"20211109","volume":"326","issue":"18","first_page":"1840","page_count":"11","accession_number":"34751704","doi":"10.1001\/jama.2021.18323","publisher":"American Medical Association","doctype":"Journal Article; Review","subjects":"Cardiology ","interest_area":["Cardiology"," Emergency Medicine"],"abstract":"Cardiogenic shock affects between 40\u202f000 and 50\u202f000 people in the US per year and is the leading cause of in-hospital mortality following acute myocardial infarction.","url":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&db=mdl&AN=34751704&authtype=shib&custid=ns346513","isPdfLink":true,"isSAML":false,"additionalInfo":{"Authored_By":"Samsky MD, Morrow DA, Proudfoot AG, Hochman JS, Thiele H, Rao SV","Journal_Info":"Publisher: American Medical Association Country of Publication: United States NLM ID: 7501160 Publication Model: Print Cited Medium: Internet ISSN: 1538-3598 (Electronic) Linking ISSN: 00987484 NLM ISO Abbreviation: JAMA Subsets: MEDLINE","Publication_Type":"Journal Article; Review","Published_Date":"2021-11-09","Source":"JAMA [JAMA] 2021 Nov 09; Vol. 326 (18), pp. 1840-1850.","Languages":"English","Electronic_ISSN":"1538-3598","MeSH_Terms":"Myocardial Infarction\/*complications , Myocardial Revascularization\/*methods , Shock, Cardiogenic\/*therapy, Cardiotonic Agents\/therapeutic use ; Extracorporeal Membrane Oxygenation ; Heart-Assist Devices ; Humans ; Percutaneous Coronary Intervention ; Shock, Cardiogenic\/etiology ; Shock, Cardiogenic\/mortality ; Shock, Cardiogenic\/physiopathology ; Time-to-Treatment","Subjects":"Cardiotonic Agents therapeutic use, Extracorporeal Membrane Oxygenation, Heart-Assist Devices, Humans, Percutaneous Coronary Intervention, Shock, Cardiogenic etiology, Shock, Cardiogenic mortality, Shock, Cardiogenic physiopathology, Time-to-Treatment, Myocardial Infarction complications, Myocardial Revascularization methods, Shock, Cardiogenic therapy","Title_Abbreviations":"JAMA","Volume":"326"},"header":{"DbId":"mdl","DbLabel":"MEDLINE Ultimate","An":"34751704","RelevancyScore":"854","PubType":"Academic Journal","PubTypeId":"academicJournal","PreciseRelevancyScore":"854.115539550781"},"plink":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&site=eds-live&db=mdl&AN=34751704&authtype=shib&custid=ns346513&group=main&profile=eds","upload_link":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&site=eds-live&db=mdl&AN=34751704&authtype=shib&custid=ns346513&group=main&profile=eds"}
["Samsky MD, Morrow DA, Proudfoot AG, Hochman JS, Thiele H, Rao SV","Publisher: American Medical Association Country of Publication: United States NLM ID: 7501160 Publication Model: Print Cited Medium: Internet ISSN: 1538-3598 (Electronic) Linking ISSN: 00987484 NLM ISO Abbreviation: JAMA Subsets: MEDLINE","Journal Article; Review","2021-11-09","JAMA [JAMA] 2021 Nov 09; Vol. 326 (18), pp. 1840-1850.","English","1538-3598","Myocardial Infarction\/*complications , Myocardial Revascularization\/*methods , Shock, Cardiogenic\/*therapy, Cardiotonic Agents\/therapeutic use ; Extracorporeal Membrane Oxygenation ; Heart-Assist Devices ; Humans ; Percutaneous Coronary Intervention ; Shock, Cardiogenic\/etiology ; Shock, Cardiogenic\/mortality ; Shock, Cardiogenic\/physiopathology ; Time-to-Treatment","Cardiotonic Agents therapeutic use, Extracorporeal Membrane Oxygenation, Heart-Assist Devices, Humans, Percutaneous Coronary Intervention, Shock, Cardiogenic etiology, Shock, Cardiogenic mortality, Shock, Cardiogenic physiopathology, Time-to-Treatment, Myocardial Infarction complications, Myocardial Revascularization methods, Shock, Cardiogenic therapy","JAMA","326"]
Description
Importance: Cardiogenic shock affects between 40 000 and 50 000 people in the US per year and is the leading cause of in-hospital mortality following acute myocardial infarction.<br />Observations: Thirty-day mortality for patients with cardiogenic shock due to myocardial infarction is approximately 40%, and 1-year mortality approaches 50%. Immediate revascularization of the infarct-related coronary artery remains the only treatment for cardiogenic shock associated with acute myocardial infarction supported by randomized clinical trials. The Percutaneous Coronary Intervention Strategies with Acute Myocardial Infarction and Cardiogenic Shock (CULPRIT-SHOCK) clinical trial demonstrated a reduction in the primary outcome of 30-day death or kidney replacement therapy; 158 of 344 patients (45.9%) in the culprit lesion revascularization-only group compared with 189 of 341 patients (55.4%) in the multivessel percutaneous coronary intervention group (relative risk, 0.83 [95% CI, 0.71-0.96]; P = .01). Despite a lack of randomized trials demonstrating benefit, percutaneous mechanical circulatory support devices are frequently used to manage cardiogenic shock following acute myocardial infarction.<br />Conclusions and Relevance: Cardiogenic shock occurs in up to 10% of patients immediately following acute myocardial infarction and is associated with mortality rates of nearly 40% at 30 days and 50% at 1 year. Current evidence and clinical practice guidelines support immediate revascularization of the infarct-related coronary artery as the primary therapy for cardiogenic shock following acute myocardial infarction.
