Background. Cardiogenic shock is the leading cause of death in patients
hospitalized for 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 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%.
Conclusion. Early invasive coronary revascularization improves short
term survival in patients with cardiogenic shock complicating acute myocardial
infarction. |
