Document Detail

Cardiogenic shock.
MedLine Citation:
PMID:  7585775     Owner:  NLM     Status:  MEDLINE    
Despite advancements in the pharmacologic treatment of acute myocardial infarction and the introduction of mechanical hemodynamic support, in-hospital mortality rates for cardiogenic shock have remained between 70% and 80%. In addition, the proven beneficial effects of thrombolytic therapy in reducing mortality in acute myocardial infarction have not been paralleled by similar results in cardiogenic shock. Emergency revascularization appears to be the only intervention that may modify the prognosis of cardiogenic shock. Because the absence of controlled data, however, final conclusions cannot yet be drawn. Two ongoing randomized clinical trials will try to answer the unsolved issues. In the multicenter international SHOCK trial (Should We Revascularize Occluded Coronaries for Cardiogenic Shock), patients are being randomized to PTCA or conservative treatment, with mortality as the primary end point. A similar end point will be evaluated in the Swiss Multicenter Study of Angioplasty for Shock following Myocardial Infarction (SMASH) trial. It is hoped that these two randomized trials will be able to prove the value of PTCA in cardiogenic shock and identify the subset of patients most likely to benefit from such treatment.
M Moscucci; E R Bates
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Cardiology clinics     Volume:  13     ISSN:  0733-8651     ISO Abbreviation:  Cardiol Clin     Publication Date:  1995 Aug 
Date Detail:
Created Date:  1995-12-14     Completed Date:  1995-12-14     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8300331     Medline TA:  Cardiol Clin     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  391-406     Citation Subset:  IM    
Division of Cardiology, University of Michigan, Ann Arbor, USA.
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MeSH Terms
Angioplasty, Transluminal, Percutaneous Coronary
Coronary Artery Bypass
Intra-Aortic Balloon Pumping
Randomized Controlled Trials as Topic
Shock, Cardiogenic* / epidemiology,  therapy
Thrombolytic Therapy
Vasoconstrictor Agents / therapeutic use
Reg. No./Substance:
0/Vasoconstrictor Agents

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