Prospective study of primary percutaneous intervention and abciximab in patients with ST elevation myocardial infarction complicated by cardiogenic shock

Zeymer, Uwe; Tebbe, U; Weber, Michael; Vöhringer, H. F.; Neuhaus, Karl-Ludwig

doi:10.1016/s0735-1097(03)81152-x

Cited by 8 publications

(9 citation statements)

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“…In our study, 37 (90.2%) patients underwent stenting in the IRA. In the REO SHOCK study 32 and other observational studies, 30,31 use of GP IIb-IIIa inhibitors was associated with improved TIMI 3 flow in the IRA in patients undergoing PCI for CS. We have used GP IIb-IIIa inhibitors in 35 (85.4%) of our patients.…”

Section: Discussionmentioning

confidence: 86%

Percutaneous coronary intervention in cardiogenic shock complicating acute ST-elevation myocardial infarction—a single centre experience

Subban

Gnanaraj

Gomathi

et al. 2012

Indian Heart Journal

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A B S T R A C TBackground: Mortality in acute myocardial infarction (AMI) complicated by cardiogenic shock (CS) approaches 70 − 80%, regardless of the type of pharmacological treatment. Early revascularisation improves survival in AMI with CS. Our aim is to assess the predictors of mid-term outcome after percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI) and CS.Methods: Forty-one patients who underwent primary or rescue PCI for CS were analysed comparing their baseline, angiographic, PCI data, 30-day and 1-year survival.Results: There were no significant differences between survivors and non-survivors in baseline characters, except for more number of transfer admissions (P = 0.0005), and cardiopulmonary resuscitations (P = 0.015) in the later group. The mean time between myocardial infarction (MI) onset to shock and MI onset to revascularisation were 12.8 ± 12.9 hours and 17.0 ± 16.8 hours, respectively. Patients with better pre-procedure thrombolysis in myocardial infarction (TIMI) flow in the infarctrelated artery (IRA) had better survival (P = 0.0005). Successful PCI was achieved in 48.8% of patients. The 30-day mortality was 56.1% and all were prior to hospital discharge. Patients with successful PCI had better short-term survival in comparison with patients with failed PCI (80% vs 9.6%). Eighteen patients who survived at 30 days were followed up for 12-72 months (mean 28.5 ± 5.4 months). Fifteen patients survived at 1 year after PCI and all were in good functional status. Conclusion:Mortality remains high even with PCI. Achieving IRA patency with TIMI 3 flow is the main determinant of survival. Survival and functional status are good in patients who are discharged from hospital.

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Section: Discussionmentioning

confidence: 86%

Percutaneous coronary intervention in cardiogenic shock complicating acute ST-elevation myocardial infarction—a single centre experience

Subban

Gnanaraj

Gomathi

et al. 2012

Indian Heart Journal

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“…The national registry of myocardial infarction reported in-hospital mortality of 47.9% in 775 US hospitals from January 1995 to May 2004 14. Patients randomized to aortic counterpulsation had significantly less reocclusion of the infarctrelated artery during fol-low-up were compared with control patients (8% versus 21%, p < 0.03).…”

Section: Discussionmentioning

confidence: 99%

Retracted: Primary Percutaneous Coronary Intervention (PPCI) in Acute Myocardial Infarction Complicated by Cardiogenic Shock in a Newly Emerging Cardiac Centre in Nepal

et al. 2017

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Background: Acute myocardial infarction (AMI) is complicated by cardiogenic shock in 7-10% of patients. Mortality rate is exceedingly high and reaches 70-80% in those treated conservatively. Large thrombolytic trials demonstrate 60% mortality with most effective thrombolytic agent. In between September 2005 to August 2008 total PCI in Shahid gangalal National Heart Centre (SGNHC), Nepal was 452. among them primary PCI (PPCI) in AMI with cardilgenic shock was done in only 16 patients with cardiogenic shock who underwent PPCI, 6 patients are in out of 50% (n=8) patients with cardiogenic shock who underwent PPCI, 6 patients are in routine follow up over 12 months and 2 were doing well in subsequent 6 months but lost in follow up afterwards. Primary PCI in AMI complicated by cardiogenic shock has lower mortality and improved outcome. High cost, high in-hospital mortality, need for trained manpower are the major limitations.

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“…In the prospective REO-SHOCK study of the ALKK the TIMI 3 flow rate was 80% with PCI and abciximab. 17 Considering the positive effect of this treatment in lower risk patients with unstable angina or STEMI Fig. 1 Influence of age on in-hospital mortality in patients with cardiogenic shock (P for trend 0.0001).…”

Section: Procedural Successmentioning

confidence: 99%

Predictors of in-hospital mortality in 1333 patients with acute myocardial infarction complicated by cardiogenic shock treated with primary percutaneous coronary intervention (PCI) Results of the primary PCI registry of the Arbeitsgemeinschaft Leitende Kardiologische Krankenhausärzte (ALKK)

Zeymer

Vogt²,

Zahn³

et al. 2004

European Heart Journal

226

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Aims Acute myocardial infarction complicated by cardiogenic shock is associated with an exceedingly high mortality, even if patients are treated with early reperfusion therapy. The aim of this study was to evaluate predictors of in-hospital mortality of a large cohort of consecutive patients with cardiogenic shock treated with primary percutaneous coronary intervention (PCI). Methods and results Between July 1994 and March 2001 all interventions performed in 80 centres in Germany were prospectively entered into the primary PCI registry of the ALKK. A total of 9422 procedures were registered, of these 1333 (14.2%) were performed in patients with cardiogenic shock. Total in-hospital mortality was 46.1% and was dependent on TIMI flow grade after PCI, with mortality rates of 78.2%, 66.1% and 37.4% in patients with TIMI 0/1, TIMI 2 and TIMI 3 flow, respectively. In a multivariate analysis left main disease, TIMI <3 flow after PCI, older age, three-vessel disease and longer time-intervals between symptom onset and PCI were significant independent predictors of mortality. The relative number of PCIs performed in patients with cardiogenic shock did not change significantly from 1995-2000. There was a significant decrease in mortality over the years (P for trend 0.02). Conclusions In-hospital mortality in patients with acute myocardial infarction complicated by cardiogenic shock remains high, even with early interventional therapy. However, our data demonstrate that the PCI in these high-risk patients is feasible in a wide spectrum of community hospitals with acceptable success rates. Our results seen in connection with the results of the randomized SHOCK study advocate an early invasive approach in younger patients with cardiogenic shock, while the best strategy in elderly patients is still a matter of debate.

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Prospective study of primary percutaneous intervention and abciximab in patients with ST elevation myocardial infarction complicated by cardiogenic shock

Cited by 8 publications

References 0 publications

Percutaneous coronary intervention in cardiogenic shock complicating acute ST-elevation myocardial infarction—a single centre experience

Percutaneous coronary intervention in cardiogenic shock complicating acute ST-elevation myocardial infarction—a single centre experience

Retracted: Primary Percutaneous Coronary Intervention (PPCI) in Acute Myocardial Infarction Complicated by Cardiogenic Shock in a Newly Emerging Cardiac Centre in Nepal

Predictors of in-hospital mortality in 1333 patients with acute myocardial infarction complicated by cardiogenic shock treated with primary percutaneous coronary intervention (PCI) Results of the primary PCI registry of the Arbeitsgemeinschaft Leitende Kardiologische Krankenhausärzte (ALKK)

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