Contemporary Management of Cardiogenic Shock

Hochman, Judith S.; Skolnick, Adam H.

doi:10.1016/j.jcin.2008.12.002

Cited by 9 publications

(5 citation statements)

References 19 publications

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“…This registry showed that older age (≥75 years) was not an independent predictor of mortality (hazard ratio 1.04, 95% CI 0.46–2.36, P = 0.93), and that there was no significant difference between the older group and the younger one in both in‐hospital mortality (42.2 vs. 33.7%, respectively; P = 0.33) and 1 year mortality (52.6 vs. 46.8%, respectively; P = 0.56). However, probably there was a bias in the selection of patients who underwent PCI [24]: the rate of patients with AMI and CS was quite small (143 out of 3,025 patients, 4.5%) and there was no notice about patients who underwent CABG or were managed medically. Furthermore, left main disease was detected only in 7.5% of elderly patients, a rate lower than that we found in our study and that is reported in the SHOCK registry [8].…”

Section: Discussionsupporting

confidence: 91%

Occupational exposures to aluminum and iron and risk of lung epithelium atypia in sudan

Ahmed

Mahmoud

Ginawi

2012

Diagnostic Cytopathology

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This study investigated the risk of lung cytological atypical changes in regards to occupational exposure to aluminum and iron. Detailed job histories were elicited from 130 incident cases with confirmed exposure to aluminum (50) or iron (80) and 157 population controls (nonexposed). Cytological atypia in sputum (dysplasia) was identified in four cases and none of controls (RR =10.8550; 95% CI = 0.5898 to 199.7815, P = 0.1086), hence, metaplasia was observed among 15 (11.5%) of the cases and 10 (6%) of controls (RR = 1.8115; 95% CI = 0.8424-3.8956; P = 0.1283). Evidences of viral infection were observed in 18 (14%) of the cases and 8 (5%) of controls (RR = 2.7173; 95% CI = 1.2213-6.0460; P = 0.0143). Moniliasis was observed in 28 (22%) of the cases and 19 (12%) of controls (RR = 1.6632; 95% CI = 0.9728-2.8435; P = 0.06). Cross-categorizations of aluminum exposure and iron use suggest greater risk associated with iron exposure than aluminum in these workers.

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Section: Discussionsupporting

confidence: 91%

Occupational exposures to aluminum and iron and risk of lung epithelium atypia in sudan

Ahmed

Mahmoud

Ginawi

2012

Diagnostic Cytopathology

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“…Consistently, the rate of PCI increased mostly among patients at higher risk, such as those with STEMI and those aged ≥75 years. In this regard, limited randomized trial data exist to direct our management of cardiogenic shock in older adults with STEMI because they are frequently under‐represented in clinical trials . Data from the SHOCK (Should We Emergently Revascularize Occluded Coronaries for Cardiogenic Shock) trial suggested that early revascularization was not superior to initial medical stabilization in 30‐day mortality among 56 patients older than 75 years .…”

Section: Discussionmentioning

confidence: 99%

Temporal trends in the epidemiology, management, and outcome of patients with cardiogenic shock complicating acute coronary syndromes

Luca

Olivari

Farina

et al. 2015

European J of Heart Fail

104

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Aims Despite advances in the management of patients with acute coronary syndrome (ACS), cardiogenic shock (CS) remains the leading cause of death in these patients. We describe the evolution of clinical characteristics, in‐hospital management, and outcome of patients with CS complicating ACS. Methods and results We analysed data from five Italian nationwide prospective registries, conducted between 2001 and 2014, including consecutive patients with ACS. Out of 28 217 ACS patients enrolled, 1209 (4.3%) had CS: 526 (44%) at the time of admission and 683 (56%) later on during hospitalization. Over the years, a reduction in the incidence of CS was observed, even though this was not statistically significant (P for trend = 0.17). The proportions of CS patients with a history of heart failure declined, whereas the proportion of those with hypertension, renal dysfunction, previous PCI, and AF significantly increased. The use of PCI considerably increased from 2001 to 2014 [19% to 60%; percentage change 41, 95% confidence interval (CI) 29–51]. In‐hospital mortality of CS patients decreased from 68% (95% CI 59–76) in 2001 to 38% (95% CI 29–47) in 2014 (percentage change −30, 95% CI −41 to −18). Compared with 2001, the risk of death was significantly lower in all of the registries, with reductions in adjusted mortality between 45% and 66%. Conclusions Over the last 14 years, substantial changes occurred in the clinical characteristics and management of patients with CS complicating ACS, with a greater use of PCI and a significant reduction in adjusted mortality rate.

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“…This registry showed that older age (!75 years) was not an independent predictor of mortality (hazard ratio 1.04, 95% CI 0.46-2.36, P ¼ 0.93), and that there was no significant difference between the older group and the younger one in both in-hospital mortality (42.2 vs. 33.7%, respectively; P ¼ 0.33) and 1 year mortality (52.6 vs. 46.8%, respectively; P ¼ 0.56). However, probably there was a bias in the selection of patients who underwent PCI [24]: the rate of patients with AMI and CS was quite small (143 out of 3,025 patients, 4.5%) and there was no notice about patients who underwent CABG or were managed medically. Furthermore, left main disease was detected only in 7.5% of elderly patients, a rate lower than that we found in our study and that is reported in the SHOCK registry [8].…”

Section: Discussionmentioning

confidence: 99%

Cardiogenic shock complicating acute myocardial infarction in the elderly: Predictors of long‐term survival

Tomassini¹,

Gagnor²,

Migliardi

et al. 2011

Cathet Cardio Intervent

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Contemporary Management of Cardiogenic Shock

Cited by 9 publications

References 19 publications

Occupational exposures to aluminum and iron and risk of lung epithelium atypia in sudan

Occupational exposures to aluminum and iron and risk of lung epithelium atypia in sudan

Temporal trends in the epidemiology, management, and outcome of patients with cardiogenic shock complicating acute coronary syndromes

Cardiogenic shock complicating acute myocardial infarction in the elderly: Predictors of long‐term survival

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