| Cardiogenic shock caused by right ventricular infarction: a report from the SHOCK registry. | |
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MedLine Citation:
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PMID: 12706920 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Journal Article; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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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:
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Created Date: 2003-04-22 Completed Date: 2003-04-30 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 1273-9 Citation Subset: AIM; IM |
Affiliation:
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Department of Medicine, Boston Medical Center, Massachusetts 02118, USA. alice.jacobs@bmc.org |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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:
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R01-HL49970/HL/NHLBI NIH HHS; R01-HL50020-018Z/HL/NHLBI NIH HHS |
| Comments/Corrections | |
Comment In:
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J Am Coll Cardiol. 2003 Apr 16;41(8):1280-2
[PMID:
12706921
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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