Early revascularization in acute myocardial infarction complicated by cardiogenic shock: impact on mortality

ABSTRACT

Cardiogenic shock is the leading cause of death in patients hospitalized for acute myocardial infarction. The study represents a retrospective analysis in 20 patients presented with cardiogenic shock secondary to left ventricular dysfunction after acute myocardial infarction. Cardiogenic shock was defined according to clinical and hemodynamic criteria. Patients with cardiogenic shock secondary to mechanical complications were excluded. Coronary angiography was done in all patients 5 patients were not eligible for revascularization, 14 patients had percutanous coronary intervention [PCI], and one patient had coronary artery bypass grafting [CABG]. The total in-hospital mortality was 45%. 100% of patients assigned to conservative treatment died during hospital stay, versus 26.6% mortality in patients who had coronary revascularization [PCI and CABG]. Among patients assigned to PCI, the in-hospital mortality was 28%. Early invasive coronary revascularization improves short term survival in patients with cardiogenic shock complicating acute myocardial infarction