Document Detail


Cardiogenic shock caused by right ventricular infarction: a report from the SHOCK registry.
MedLine Citation:
PMID:  12706920     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The purpose of this study was to determine the characteristics and outcomes of patients with acute myocardial infarction (MI) complicated by cardiogenic shock due to predominant right ventricular (RV) infarction. BACKGROUND: Although RV infarction has been shown to have favorable long-term outcomes, the influence of RV infarction on mortality in cardiogenic shock is unknown. METHODS: We evaluated 933 patients in cardiogenic shock due to predominant RV (n = 49) or left ventricular (LV) failure (n = 884) in the SHould we emergently revascularize Occluded coronaries for Cardiogenic shocK? (SHOCK) trial registry. RESULTS: Patients with predominant RV shock were younger, with a lower prevalence of previous MI (25.5 vs. 40.1%, p = 0.047), anterior MI, and multivessel disease (34.8 vs. 77.8%, p < 0.001) and a shorter median time between the index MI and the diagnosis of shock (2.9 vs. 6.2 h, p = 0.003) in comparison to patients with LV shock. In-hospital mortality was 53.1% versus 60.8% (p = 0.296) for patients with predominant RV and LV shock, respectively, and the influence of revascularization on mortality was not different between groups. Multivariate analysis revealed that RV shock was not an independent predictor of lower in-hospital mortality (odds ratio 1.07, 95% confidence interval 0.54 to 2.13). CONCLUSIONS: Despite the younger age, lower rate of anterior MI, and higher prevalence of single-vessel coronary disease of RV compared with LV shock patients, and their similar benefit from revascularization, mortality is unexpectedly high in patients with predominant RV shock and similar to patients with LV shock.
Authors:
Alice K Jacobs; Jane A Leopold; Eric Bates; Lisa A Mendes; Lynn A Sleeper; Harvey White; Ravin Davidoff; Jean Boland; Sharada Modur; Robert Forman; Judith S Hochman
Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  41     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2003 Apr 
Date Detail:
Created Date:  2003-04-22     Completed Date:  2003-04-30     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1273-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, Boston Medical Center, Massachusetts 02118, USA. alice.jacobs@bmc.org
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MeSH Terms
Descriptor/Qualifier:
Aged
Coronary Angiography
Female
Hemodynamics
Hospital Mortality
Humans
Male
Middle Aged
Myocardial Infarction / complications*,  mortality*,  physiopathology,  therapy
Odds Ratio
Randomized Controlled Trials as Topic
Registries
Shock, Cardiogenic / etiology*,  mortality*,  physiopathology,  therapy
Time Factors
Ventricular Dysfunction, Left / complications*,  mortality,  therapy
Ventricular Dysfunction, Right / complications*,  mortality,  therapy
Grant Support
ID/Acronym/Agency:
R01-HL49970/HL/NHLBI NIH HHS; R01-HL50020-018Z/HL/NHLBI NIH HHS
Comments/Corrections
Comment In:
J Am Coll Cardiol. 2003 Apr 16;41(8):1280-2   [PMID:  12706921 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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