EARLYREVASCULARIZATIONINACUTE MYOCARDIAL INFARCTIONCOMPLICATEDBY CARDIOGENIC SHOCK: IMPACT ONMORTALITY
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Background. Cardiogenic shock is the leajding cause of death in pa tients hospitalizedfor acute myocardial infarction. Patients and results. 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 secon dary 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 (CABC). The total in-hospital mortality was 45%. 100% ofpatients assigned to conservative treatment died during hospital stay, versus 26.6% mortality in patients who had coronary revascuiarization (PCI and CABG). Among patients assigned to PCI, the in-hospitalmortalitywas 28%. Conclusion. Early invasive coronary revascuiarization improves short termsurvival in patients with cardiogenic shock complicating acute myo cardial infarction.