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Titolo:
Cardiogenic shock complicating acute myocardial infarction - Etiologies, management and outcome: A report from the SHOCK Trial Registry
Autore:
Hochman, JS; Buller, CE; Sleeper, LA; Boland, J; Dzavik, V; Sanborn, TA; Godfrey, E; White, HD; Lim, J; LeJemtel, T;
Indirizzi:
Columbia Univ, St Lukes Roosevelt Hosp Ctr, New York, NY 10025 USA Columbia Univ New York NY USA 10025 velt Hosp Ctr, New York, NY 10025 USA Vancouver Hosp & Hlth Sci Ctr, Vancouver, BC V5Z 1M9, Canada Vancouver Hosp & Hlth Sci Ctr Vancouver BC Canada V5Z 1M9 V5Z 1M9, Canada New England Res Inst, Watertown, MA 02172 USA New England Res Inst Watertown MA USA 02172 Inst, Watertown, MA 02172 USA CHR Citadelle, Dept Cardiol, Liege, Belgium CHR Citadelle Liege BelgiumCHR Citadelle, Dept Cardiol, Liege, Belgium Univ Alberta, Div Cardiol, Edmonton, AB, Canada Univ Alberta Edmonton AB Canada berta, Div Cardiol, Edmonton, AB, Canada New York Cornell Med Ctr, New York, NY USA New York Cornell Med Ctr New York NY USA rnell Med Ctr, New York, NY USA Green Lane Hosp, Auckland 3, New Zealand Green Lane Hosp Auckland New Zealand 3 ane Hosp, Auckland 3, New Zealand Albert Einstein Med Ctr, Coll Med, New York, NY USA Albert Einstein Med Ctr New York NY USA Ctr, Coll Med, New York, NY USA
Titolo Testata:
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
fascicolo: 3, volume: 36, anno: 2000, supplemento:, A
pagine: 1063 - 1070
SICI:
0735-1097(200009)36:3<1063:CSCAMI>2.0.ZU;2-O
Fonte:
ISI
Lingua:
ENG
Soggetto:
EARLY REVASCULARIZATION; CORONARY ANGIOPLASTY; IMPROVES SURVIVAL; MORTALITY; RUPTURE; BYPASS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
35
Recensione:
Indirizzi per estratti:
Indirizzo: Hochman, JS Columbia Univ, St Lukes Roosevelt Hosp Ctr, 1111 Amsterdam Ave, New York, NY 10025 USA Columbia Univ 1111 Amsterdam Ave New York NY USA 10025 025 USA
Citazione:
J.S. Hochman et al., "Cardiogenic shock complicating acute myocardial infarction - Etiologies, management and outcome: A report from the SHOCK Trial Registry", J AM COL C, 36(3), 2000, pp. 1063-1070

Abstract

OBJECTIVES This SHOCK Study report seeks to provide an overview of patients with cardiogenic shock (CS) complicating acute myocardial infarction (MI)and the outcome with various treatments. The outcome of patients undergoing revascularization in the SHOCK Trial Registry and SHOCK Trial are compared. BACKGROUND Cardiogenic shock is the leading cause of death in patients hospitalized for acute MI. The randomized SHOCK Trial reported improved six-month survival with early revascularization. METHODS Patients with CS complicating acute MI who were not enrolled in the concurrent randomized trial were registered. Patient characteristics wererecorded as were procedures and vital status at hospital discharge. RESULTS Between April 1993 and August 1997, 1,190 patients with CS were registered and 232 were randomized in the SHOCK Trial. Predominant left ventricular failure (78.5%) was most common, with isolated right ventricular shock in 2.8%, severe mitral regurgitation in 6.9%, ventricular septal rupturein 3.9% and tamponade in 1.4%. In-hospital Registry mortality was 60%, with ventricular septal rupture associated with a significantly higher mortality (87.3%) than all other categories (p < 0.01). The risk profile and mortality were lower for Registry patients who were managed with thrombolycic therapy and/or intra-aortic balloon counterpulsation, coronary angiography, angioplasty and/or coronary artery bypass surgery. After adjusting for thesedifferences, the extent to which survival was improved with early revascularization was similar to that observed in the randomized SHOCK Trial. CONCLUSIONS In this prospective Registry the etiology of CS was a mechanical complication in 12%. The similarity of the beneficial treatment effect in patients undergoing early revascularization in the SHOCK Trial Registry and SHOCK Trial provides strong support for the generalizability of the SHOCK Trial results. (J Am Coil Cardiol 2000;36:1063-70) (C) 2000 by the American College of Cardiology.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 27/11/20 alle ore 15:36:47