Document Detail

Elective coronary stent implantation in cardiogenic shock complicating acute myocardial infarction: in-hospital and six-month clinical and angiographic results.
MedLine Citation:
PMID:  10931605     Owner:  NLM     Status:  MEDLINE    
Effective treatment of patients with acute myocardial infarction and cardiogenic shock depends on restoring persistent patency of the infarct-related artery. Coronary stenting, reducing abrupt or delayed closure related to dissection and suboptimal result, may improve PTCA results in cardiogenic shock. Eighteen patients (14 males and 4 females, mean age 59 +/- 7 years), referred to catheterization laboratory for acute myocardial infarction and shock, had elective stent implantation during 14 primary and 4 rescue PTCA. Time delay between shock onset and PTCA was 4.1 +/- 3 hr (range, 30 min to 12 hr). The IRA was LAD in seven patients (38%), LCx in two (11%), and RCA in eight (45%). One patient (5.%) had distal LMCA occlusion. Stent deployment was successful in 100% of patients and resulted in TIMI 3 flow in 13 (72%) patients. In 13 (72%) cases, cardiogenic shock gradually resolved and the patients were discharged alive. Five patients (28%) died because of irreversible hemodynamic deterioration without evidence of reinfarction. At 6-month follow-up, all the discharged patients were alive and no patient had reinfarction or recurrent angina. Heart transplant was required in one patient 5 months after stenting because of refractory congestive heart failure. Angiography demonstrated patency of all the coronary arteries treated, with TIMI 3 flow in all patients. Stent restenosis rate was 30%, and target lesion revascularization with CABG or re-PTCA was not required in any case. LV function improved from 39% +/- 15% to 51% +/- 15% (P < 0.01). Elective coronary stenting is an effective treatment for acute myocardial infarction complicated by cardiogenic shock and may improve acute and long-term survival.
F Fabbiocchi; A L Bartorelli; P Montorsi; S Cozzi; D Trabattoni; G Calligaris; A Loaldi
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  50     ISSN:  1522-1946     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2000 Aug 
Date Detail:
Created Date:  2000-09-15     Completed Date:  2000-09-15     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  384-9     Citation Subset:  IM    
Institute of Cardiology, University of Milan, Fondazione "Monzino" Italy.
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MeSH Terms
Angioplasty, Transluminal, Percutaneous Coronary / methods*
Coronary Angiography*
Disease-Free Survival
Follow-Up Studies
Middle Aged
Myocardial Infarction / complications*,  physiopathology,  radiography,  surgery
Retrospective Studies
Shock, Cardiogenic / etiology,  physiopathology,  radiography,  surgery*
Surgical Procedures, Elective*
Ventricular Function, Left

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