CABG Tied to Lower Death Rate in MI Complicated by Cardiogenic Shock CABG Tied to Lower Death Rate in MI Complicated by Cardiogenic Shock

Coronary-artery-bypass grafting (CABG) is associated with lower in-hospital mortality in myocardial infarction (MI) complicated by cardiogenic shock, compared with percutaneous coronary intervention (PCI), according to a database study.Reuters Health Information
Source: Medscape General Surgery Headlines - Category: Surgery Tags: Cardiology News Source Type: news

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Purpose of review Early revascularization significantly improved the outcome of patients with cardiogenic shock following acute myocardial infarction (AMI). Nevertheless, the mortality remains substantial, ranging between 40 and 50% after 30 days. The present review summarizes the current evidence regarding revascularization strategies, vascular access site and concomitant antiplatelet and antithrombotic treatment in infarct-related cardiogenic shock. Recent findings On the basis of the SHOCK trial, early revascularization is the most relevant procedure to improve the outcome of patients with infarct-related cardiogen...
Source: Current Opinion in Critical Care - Category: Nursing Tags: CARDIOGENIC SHOCK: Edited by Alexandre Mebazaa Source Type: research
We report the first U.S. experience of the recently approved micro-axial surgical heart pump for the treatment of ongoing cardiogenic shock following acute myocardial infarction (AMICGS), postcardiotomy cardiogenic shock (PCCS), cardiomyopathy including myocarditis, high-risk percutaneous coronary intervention (HRPCI), and coronary artery bypass surgery (HRCABG). Demographic, procedural, hemodynamic, and outcome data were obtained from the manufacturer’s quality database of all Impella 5.5 implants at three centers. Fifty-five patients underwent an Impella 5.5 implant for cardiomyopathy (45%), AMICGS (29%), PCCS (13%...
Source: ASAIO Journal - Category: Medical Devices Tags: Adult Circulatory Support Source Type: research
VenoArterial ExtraCorporeal Membrane Oxygenation (VA-ECMO) provides blood oxygenation and end-organ perfusion in patients with cardiogenic shock, and has shown to have benefits on refractory cardiogenic shock [1], percutaneous coronary intervention for ST-segment elevation myocardial infarction with refractory cardiogenic shock [2], and coronary artery bypass grafting [3]. However, VA-ECMO is also known to increase left ventricular (LV) afterload, leading to LV distension and pulmonary congestion [4].
Source: International Journal of Cardiology - Category: Cardiology Authors: Tags: Editorial Source Type: research
Publication date: Available online 12 March 2020Source: American Heart JournalAuthor(s): Nathaniel R. Smilowitz, Carlos L. Alviar, Stuart D. Katz, Judith S. Hochman
Source: American Heart Journal - Category: Cardiology Source Type: research
CONCLUSIONS: Complications requiring ICU care were infrequent in a cohort of NSTEMI patients who were routinely admitted to the ICU over a 4-year period. The ACTION risk score had low accuracy in the prediction of complications requiring ICU care in our population. PMID: 32089424 [PubMed - as supplied by publisher]
Source: European Journal of Internal Medicine - Category: Internal Medicine Authors: Tags: Eur J Intern Med Source Type: research
Abstract BACKGROUND: Patients presenting with acute coronary syndrome (ACS) from left main (LM) disease are at a high risk for mortality despite recent advancement in devices and techniques during percutaneous coronary interventions (PCI). We aimed to evaluate patient characteristics, clinical presentations, and key clinical characteristics associated with adverse in-hospital outcomes among ACS patients undergoing LM-PCI. METHODS: We retrospectively identified 280 LM-ACS patients (3.7 %) from 7608 ACS patients in the prospective multicenter Japan Cardiovascular Database-Keio Inter-Hospital Cardiovascular Stud...
Source: Journal of Cardiology - Category: Cardiology Authors: Tags: J Cardiol Source Type: research
Post by Smith and MeyersSam Ghali (https://twitter.com/EM_RESUS) just asked me (Smith):" Steve, do left main coronary artery *occlusions* (actual ones with transmural ischemia) have ST Depression or ST Elevation in aVR? "Smith and Meyers answer:First, LM occlusion is uncommon in the ED because most of these die before they can get a 12-lead recorded.But if they do present:The very common presentation of diffuse STD with reciprocal STE in aVR is NOT left main occlusion, though it might be due to subtotal LM ACS, but is much more often due to non-ACS conditions, especially demand ischemia. ...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
Abstract BACKGROUND: Despite the increasing number of patients after percutaneous coronary intervention (PCI) requiring coronary artery bypass grafting (CABG), studies on the impact of these procedures on surgical revascularisation outcomes are sparse. Furthermore, advances in cardiology require reassessment of their potential prognostic significance. AIM: We sought to assess the influence of previous PCI on CABG outcomes. METHODS: A total of 211 consecutive patients scheduled for CABG were enrolled into this prospective study. Patients after PCI (group 1, n = 99) were compared with subjects with no hist...
Source: Kardiologia Polska - Category: Cardiology Authors: Tags: Kardiol Pol Source Type: research
This case comes from Sam Ghali  (@EM_RESUS). A 60-year-old man calls 911 after experiencing sudden onset chest pain, palpitations, and shortness of breath. Here are his vital signs:HR: 130-160, BP: 140/75, RR:22, Temp: 98.5 F, SaO2: 98%This is his 12-Lead ECG:He is in atrial fibrillation with a rapid ventricular response at a rate of around 140 bpm. There are several abberantly conducted beats. There is ST-Elevation in aVR of several millimeters and diffuse ST-Depression with the maximal depression vector towards Lead II in the limb leads and towards V5 in the precordial leads.ECG reading is all ab...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
In this issue of the Journal, Rohn et al. report their experience with urgent coronary bypass graft surgery (CABG) for patients with ST-segment elevation acute myocardial infarction (STEMI), operated within 24hours of the onset of symptoms [1]. This usually occurred in the situation where percutaneous coronary intervention (PCI) with balloon or stent had either failed or was not possible. They report their results on 135 patients, documenting an early mortality of 8.1%, and demonstrating that the major risk factor for early death is poor haemodynamic status at presentation, measured as either Killip class or with cardiogenic shock.
Source: Heart, Lung and Circulation - Category: Cardiology Authors: Tags: Editorial Source Type: research
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