Skip to main content
SpringerLink
Log in

Cardiogenic shock in myocardial infarction-results of in-hospital follow-up

  • Research Article
  • Published:
Central European Journal of Medicine

Abstract

The purpose of this study was to present the outcomes of treatment of cardiogenic shock (CS) complicating acute myocardial infarction (AMI) among patients hospitalized from 1999 through 2006. The study enrolled 1003 patients. Group 1 comprised 87 patients presenting with AMI complicated with CS, whereas Group 2 comprised 916 patients presenting with AMI without CS symptoms. Determination of invasive treatment was according to standard guidelines. The endpoint comprised death, stroke, and reocclusion/reinfarction. Follow-up was confined to the intra-hospital period. CS was observed more frequently in cases of ST-elevation MI (STEMI) and right ventricular MI. The transportation and door-to-needle time were shorter in Group 1. CS patients were characterized by a more severe coronary artery disease, higher maximal creatinine kinase levels, lower global ejection fractions, and increased incidence of atrioventricular conduction disorders. The efficacy of percutaneous coronary intervention (PCI) was 82.26% in Group 1 and 95.03% in Group 2. Death occurred in 33.3% of CS patients and in 3.6% of AMI patients (p<0.0001). Our study proved that in a short-term follow-up, PCI is a procedure of high efficacy in CS patients. The short-term follow-up precluded a conclusion of statistically significant benefits from the shortening of the transportation and door-to-needle time.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Hochman JS, Buller CE, Sleeper LA. Cardiogenic shock complicated myocardial infarction — etiologies, management and outcome: A Report from the SHOCK Trial Registry. J Am Coll Cardiol 2000; 36:1063–1070

    Article  CAS  PubMed  Google Scholar 

  2. Menon V, White H, LeJemtel T, Webb JG, Sleeper LA, Hochman JS. The clinical profile of patients with suspected cardiogenic shock due to predominant left ventricular failure: a report from the Shock Trial Registry. Should we emergently revascularize Occluded Coronaries in cardiogenic shock? J Am Coll Cardiol 2000; 36:1071–1076

    Article  CAS  PubMed  Google Scholar 

  3. Jacobs AK, Leopold JA, Bates E, Mendes LA, Sleeper LA, White H et al. Cardiogenic shock caused by right ventricular infarction: a report from Shock registry. J Am Coll Cardiol 2003; 41:1273–1279

    Article  PubMed  Google Scholar 

  4. The Joint European Society of Cardiology/American College of Cardiology Committee. Myocardial infarction redefined: A consensus document of The Joint European Society of Cardiology/American College of Cardiology Committee for the Redefinition of Myocardial Infarction. Eur Heart J. 2000; 21:1502–1513; J Am Coll Cardiol. 2000; 36:959–69

    Article  Google Scholar 

  5. Holmes DR Jr. Cardiogenic shock: A lethal complication of acute myocardial infarction. Rev Cardiovasc Med 2003 Summer;4(3):131–135

    PubMed  Google Scholar 

  6. Bates ER, Topol EJ. Limitation of thrombolytic therapy for acute myocardial infarction complicated by congestive heart failure and cardiogenic shock. J Am Coll Cardiol 1991; 18:1077–1084

    Article  CAS  PubMed  Google Scholar 

  7. Gruppo Italiano per lo Studio della Streptochinasi nell’Infarcto Miocardico (GISSI). Effectivness of intravenous thrombolytic treatment in acute myocardial infarction. Lancet 1986; 1:397–401

    Google Scholar 

  8. De Luca G, Savonitto S, Greco C, Parodi G, Dajelli Ermolli NC, Silva C et al. BLITZ Investigators Cardiogenic shock developing in the coronary care unit in patients with ST-elevation myocardial infarction. J Cardiovasc Med (Hagerstown). 2008 Oct;9(10):1023–1029

    Article  Google Scholar 

  9. Hochman JS, Sleeper LA, White HD, Dzavik V, Wong SC, Menon V et al. One-Year Survival Following Early Revascularization for cardiogenic shock. JAMA 2001;285(2):190–192

    Article  CAS  PubMed  Google Scholar 

  10. Jeger RV, Harkness SM, Ramanathan K, Buller CE, Pfisterer ME, Sleeper LA et al. Emergency revascularization in patients with cardiogenic shock on admission: a report from the SHOCK trial and registry. Eur Heart J. 2006 Mar;27(6):664–670

    Article  PubMed  Google Scholar 

  11. Tarantini G, Ramondo A, Napodano M, Balato C, Isabella G, Razzolini R et al. Myocardial perfusion grade and survival after percutaneous transluminal coronary angioplasty in patients with cardiogenic shock. Am J Cardiol. 2004 May 1;93(9):1081–1085

    Article  PubMed  Google Scholar 

  12. Ortolani P, Marzocchi A, Marrozzini C, Palmerini T, Saia F, Serantoni C et al. Clinical impact of direct referral to primary percutaneous coronary intervention following pre-hospital diagnosis of ST-elevation myocardial infarction. Eur Heart J 2006; 27(13):1550–1557

    Article  PubMed  Google Scholar 

  13. Thiele H, Smalling RW, Schuler GC. Percutaneous left ventricular assist devices in acute myocardial infarction complicated by cardiogenic shock. Eur Heart J. 2007 Sep;28(17):2057–2063

    Article  PubMed  Google Scholar 

  14. Santa-Cruz RA, Cohen MG, Ohman EM. Aortic counterpulsation: a review of the hemodynamic effects and indications for use. Catheter Cardiovasc Interv. 2006 Jan;67(1):68–77

    Article  PubMed  Google Scholar 

  15. Holmes DR Jr, Bates ER, Kleiman NS, Sadowski Z, Horgan JH, Morris DC et al. Contemporary reperfusion therapy for cardiogenic shock: the GUSTO-I trial experience. J Am Coll Cardiol 1995; 26:668–674

    Article  PubMed  Google Scholar 

  16. Gąsior M, Wasilewski J, Gierlotka M, Zębik T, Szkodziński J, Kondys M et al. Cardiogenic shock in the course of myocardial infarction — the results of treatment during hospitalization and in long-term follow-up. Wiad Lek 2003; 56(1–2):4–9

    PubMed  Google Scholar 

  17. Wong SC, Sanborn T, Sleeper LA, Webb JG, Pilchik R, Hart D et al. Angiographic findings and clinical correlates in patients with cardiogenic shock complicating acute myocardial infarction: a report from the shock Trial Registry. J Am Coll Cardiol. 2000; 36:1077–1083

    Article  CAS  PubMed  Google Scholar 

  18. Barbash IM, Behar S, Battler A, Hasdai D, Boyko V, Gottlieb S et al. Management and outcome of cardiogenic shock complicating acute myocardial infarction in hospitals with and without on-site catheterisation facilities. Heart. 2001 Aug;86(2):145–149

    Article  CAS  PubMed  Google Scholar 

  19. Lee MS, Tseng CH, Barker CM, Menon V, Steckman D, Shemin R et al. Outcome after surgery and percutaneous intervention for cardiogenic shock and left main disease. Ann Thorac Surg. 2008 Jul;86(1):29–34

    Article  PubMed  Google Scholar 

  20. White HD, Assmann SF, Sanborn TA, Jacobs AK, Webb JG, Sleeper LA et al. Comparison of percutaneous coronary intervention and coronary artery bypass grafting after acute myocardial infarction complicated by cardiogenic shock: results from the Should We Emergently Revascularize Occluded Coronaries for Cardiogenic Shock (SHOCK) trial. Circulation. 2005 Sep 27;112(13):1992–2001

    Article  PubMed  Google Scholar 

  21. Webb JG, Lowe AM, Sanborn TA, White HD, Sleeper LA, Carere RG et al. Percutaneous coronary intervention for cardiogenic shock in the SHOCK trial. J Am Coll Cardiol. 2003 Oct 15;42(8):1380–1386

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. 2nd Department of Cardiology, Zabrze, Silesian Medical University of Katowice, Zabrze, 41-800, Poland

    Damian Kawecki, Beata Morawiec, Renata Rybczyk, Zofia Trzepaczyńska, Brygida Przywara-Chowaniec, Celina Wojciechowska, Marcin Fudal, Przemysław Wilczewski, Wojciech Jacheć & Ewa Nowalany-Kozielska

Authors
  1. Damian Kawecki
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Beata Morawiec
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Renata Rybczyk
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Zofia Trzepaczyńska
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Brygida Przywara-Chowaniec
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Celina Wojciechowska
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Marcin Fudal
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Przemysław Wilczewski
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Wojciech Jacheć
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Ewa Nowalany-Kozielska
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Damian Kawecki.

About this article

Cite this article

Kawecki, D., Morawiec, B., Rybczyk, R. et al. Cardiogenic shock in myocardial infarction-results of in-hospital follow-up. cent.eur.j.med 6, 213–219 (2011). https://doi.org/10.2478/s11536-010-0076-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2478/s11536-010-0076-8

Keywords

Search

Navigation