Current clinical management of acute myocardial infarction complicated by cardiogenic shock.

Current clinical management of acute myocardial infarction complicated by cardiogenic shock. Expert Rev Cardiovasc Ther. 2020 Dec 08;: Authors: El Nasasra A, Zeymer U Abstract INTRODUCTION: Cardiogenic shock (CS) remains the leading cause of death among patients admitted with acute myocardial infarction (AMI). Early restoration of blood flow of the infarct-related artery is of paramount importance, either with percutaneous coronary intervention (PCI) or with coronary artery bypass grafting (CABG). In addition early risk stratification is a critical task and required to guide complex decisions on management and therapy of CS after AMI. The use of short-term mechanical circulatory support (MCS) is increasing, although evidence for their effectiveness is limited. AREAS COVERED: We review the evidence for early revascularization of the culprit-lesion and risk stratification in patients with AMI complicated by cardiogenic shock. The current data for the use of MCS will be discussed and put into clinical perspective. EXPERT OPINION: The SHOCK trial has introduced an early invasive strategy with subsequent revascularization as standard of care in patients with AMI complicated by CS. In clinical practice PCI is the by far the most often used revascularization therapy in CS. Most important is restoration of normal flow (so called TIMI 3 patency) of the infarct artery to reduce mortality. Therefore, all efforts including intens...
Source: Expert Review of Cardiovascular Therapy - Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research