Current spectrum and outcomes of infarct-related cardiogenic shock

• Verfasst von: Zeymer, Uwe [VerfasserIn]
• Verfasst von: Heer, Tobias [VerfasserIn]
• Verfasst von: Ouarrak, Taoufik [VerfasserIn]
• Verfasst von: Akın, Ibrahim [VerfasserIn]
• Verfasst von: Noc, Marko [VerfasserIn]
• Verfasst von: Stepinska, Janina [VerfasserIn]
• Verfasst von: Oldroyd, Keith [VerfasserIn]
• Verfasst von: Serpytis, Pranas [VerfasserIn]
• Verfasst von: Montalescot, Giles [VerfasserIn]
• Verfasst von: Huber, Kurt [VerfasserIn]
• Verfasst von: Windecker, Stephan [VerfasserIn]
• Verfasst von: Savonitto, Stefano [VerfasserIn]
• Verfasst von: Vrints, Christiaan [VerfasserIn]
• Verfasst von: Schneider, Steffen [VerfasserIn]
• Verfasst von: Desch, Steffen [VerfasserIn]
• Verfasst von: Thiele, Holger [VerfasserIn]
• Titel: Current spectrum and outcomes of infarct-related cardiogenic shock
• Titelzusatz: insights from the CULPRIT-SHOCK registry and randomized controlled trial
• Verf.angabe: Uwe Zeymer, Tobias Heer, Taoufik Ouarrak, Ibrahim Akin, Marko Noc, Janina Stepinska, Keith Oldroyd, Pranas Serpytis, Giles Montalescot, Kurt Huber, Stephan Windecker, Stefano Savonitto, Christiaan Vrints, Steffen Schneider, Steffen Desch, and Holger Thiele, on behalf of the CULPRIT-SHOCK Investigators
• E-Jahr: 2024
• Jahr: April 2024
• Umfang: 12 S.
• Illustrationen: Illustrationen
• Fussnoten: Veröffentlicht: 13. Februar 2024 ; Gesehen am 23.08.2024
• Titel Quelle: Enthalten in: European heart journal - acute cardiovascular care
• Ort Quelle: Oxford : Oxford University Press, 2012
• Jahr Quelle: 2024
• Band/Heft Quelle: 13(2024), 4 vom: Apr., Seite 335-346
• ISSN Quelle: 2048-8734
• DOI: doi:10.1093/ehjacc/zuae020
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1899443932

Abstract

We analysed consecutive patients with acute myocardial infarction complicated by cardiogenic shock (CS) who were enrolled into the CULPRIT-SHOCK randomized controlled trial (RCT) and those with exclusion criteria who were included into the accompanying registry.In total, 1075 patients with infarct-related CS were screened for CULPRIT-SHOCK in 83 specialized centres in Europe; 369 of them had exclusion criteria for the RCT and were enrolled into the registry. Patients were followed over 1 year. The mean age was 68 years and 260 (25%) were women. 13.5%, 30.9%, and 55.6% had one-vessel, two-vessel, and three-vessel coronary artery disease (CAD), respectively. Significant left main (LM) coronary artery stenosis was present in 8.0%. 54.2% of the patients had cardiac arrest before admission. Thrombolysis in myocardial infarction (TIMI) 3 patency of the infarct vessel after percutaneous coronary intervention was achieved in 83.6% of all patients. Mechanical circulatory support was applied in one-third of patients. Total mortality after 30 days and 1 year was 47.6% and 52.9%. Mortality after 1 year was highest in patients with LM coronary artery stenosis (63.5%), followed by three-vessel (56.6%), two-vessel (49.8%), and one-vessel CAD (38.6%), respectively. Mechanical complications were rare (21/1008; 2.1%) but associated with a high mortality of 66.7% after 1 year.In specialized centres in Europe, short- and long-term mortality of patients with infarct-related CS treated with an invasive strategy is still high and mainly depends on the extent of CAD. Therefore, there is still a need for improvement of care to improve the prognosis of infarct-related CS.