Document Detail

Cardiogenic shock without flow-limiting angiographic coronary artery disease: (from the Should We Emergently Revascularize Occluded Coronary Arteries for Cardiogenic Shock Trial and Registry).
MedLine Citation:
PMID:  19576316     Owner:  NLM     Status:  MEDLINE    
Myocardial infarction often develops when thrombosis occurs at lesions that have not previously been flow limiting. However, the development of cardiogenic shock complicating acute myocardial infarction in such circumstances has received little attention. The characteristics of 15 patients with cardiogenic shock who had no flow-limiting angiographic stenoses were compared with those of 767 patients with > or =1 stenosis who were enrolled in the Should We Emergently Revascularize Occluded Coronary Arteries for Cardiogenic Shock (SHOCK) trial and registry. Compared with patients with > or =1 flow-limiting stenosis, patients with no flow-limiting stenoses were less likely to have pulmonary edema on chest x-ray (29% vs 62%, p = 0.008) and to be white (53% vs 82%, p = 0.011), and they had lower median highest creatine kinase levels (702 vs 2,731 U/L, p = 0.018). For SHOCK trial patients, 1-year survival was 49% for patients with > or =1 flow-limiting stenosis and 71% for those with no flow-limiting stenoses (p = 0.268). In conclusion, patients with cardiogenic shock without flow-limiting stenosis have different characteristics, and potentially disease mechanisms, and they do not require revascularization.
John K French; Shannon Harkness; Lynn Sleeper; S Chiu Wong; Jacques Col; Vladimir Dzavik; Harvey D White; Judith S Hochman
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Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial     Date:  2009-05-04
Journal Detail:
Title:  The American journal of cardiology     Volume:  104     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-07-06     Completed Date:  2009-07-24     Revised Date:  2014-09-18    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  24-8     Citation Subset:  AIM; IM    
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MeSH Terms
Coronary Angiography*
Coronary Stenosis / complications,  mortality,  therapy*
Coronary Vessels / pathology*
Middle Aged
Myocardial Infarction / complications*,  mortality,  therapy
Risk Factors
Shock, Cardiogenic / etiology,  mortality,  therapy*
Ventricular Function, Left
Grant Support
R01 HL049970-10/HL/NHLBI NIH HHS; R01 HL050020/HL/NHLBI NIH HHS; R01 HL050020-05/HL/NHLBI NIH HHS

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