| Percutaneous coronary intervention for cardiogenic shock in the SHOCK Trial Registry. | |
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MedLine Citation:
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PMID: 11376311 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The SHOCK Registry prospectively enrolled patients with cardiogenic shock complicating acute myocardial infarction in 36 multinational centers. METHODS: Cardiogenic shock was predominantly attributable to left ventricular pump failure in 884 patients. Of these, 276 underwent percutaneous coronary intervention (PCI) after shock onset and are the subject of this report. RESULTS: The majority (78%) of patients undergoing angiography had multivessel disease. As the number of diseased arteries rose from 1 to 3, mortality rates rose from 34.2% to 51.2%. Patients who underwent PCI had lower in-hospital mortality rates than did patients treated medically (46.4% vs 78.0%, P < .001), even after adjustment for patient differences and survival bias (P = .037). Before PCI, the culprit artery was occluded (Thrombolysis In Myocardial Infarction grade 0 or 1 flow) in 76.3%. After PCI, the in-hospital mortality rate was 33.3% if reperfusion was complete (grade 3 flow), 50.0% with incomplete reperfusion (grade 2 flow), and 85.7% with absent reperfusion (grade 0 or 1 flow) (P < .001). CONCLUSIONS: This prospective, multicenter registry of patients with acute myocardial infarction complicated by cardiogenic shock is consistent with a reduction in mortality rates as the result of percutaneous coronary revascularization. Coronary artery patency was an important predictor of outcome. Measures to promote early and rapid reperfusion appear critically important in improving the otherwise poor outcome associated with cardiogenic shock. |
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Authors:
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J G Webb; T A Sanborn; L A Sleeper; R G Carere; C E Buller; J N Slater; K W Baran; P T Koller; J D Talley; M Porway; J S Hochman; |
Publication Detail:
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Type: Journal Article; Multicenter Study; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: American heart journal Volume: 141 ISSN: 0002-8703 ISO Abbreviation: Am. Heart J. Publication Date: 2001 Jun |
Date Detail:
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Created Date: 2001-05-28 Completed Date: 2001-06-21 Revised Date: 2007-11-14 |
Medline Journal Info:
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Nlm Unique ID: 0370465 Medline TA: Am Heart J Country: United States |
Other Details:
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Languages: eng Pagination: 964-70 Citation Subset: AIM; IM |
Affiliation:
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St Paul's Hospital, Vancouver, British Columbia, Canada. webb@providencehealth.bc.ca |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Angioplasty, Transluminal, Percutaneous Coronary* Canada / epidemiology Female Humans Male Myocardial Infarction / mortality, therapy Prospective Studies Registries Shock, Cardiogenic / mortality*, therapy* Survival Analysis United States / epidemiology |
| Grant Support | |
ID/Acronym/Agency:
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R01 HL49970/HL/NHLBI NIH HHS; R01 HL50020/HL/NHLBI NIH HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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