Cardiogenic shock caused by right ventricular infarction: A report from the SHOCK registry

Alice K. Jacobs, Jane A. Leopold, Eric Bates, Lisa A. Mendes, Lynn A. Sleeper, Harvey White, Ravin Davidoff, Jean Boland, Sharada Modur, Robert Forman, Judith S. Hochman

Research output: Contribution to journalArticle

Abstract

OBJECTIVES: The purpose of this study was to determine the characteristics and outcomes of patients with acute myocardial infarction (MI) complicated by cardiogenic shock due to predominant right ventricular (RV) infarction. BACKGROUND: Although RV infarction has been shown to have favorable long-term outcomes, the influence of RV infarction on mortality in cardiogenic shock is unknown. METHODS: We evaluated 933 patients in cardiogenic shock due to predominant RV (n = 49) or left ventricular (LV) failure (n = 884) in the SHould we emergently revascularize Occluded coronaries for Cardiogenic shocK? (SHOCK) trial registry. RESULTS: Patients with predominant RV shock were younger, with a lower prevalence of previous MI (25.5 vs. 40.1%, p = 0.047), anterior MI, and multivessel disease (34.8 vs. 77.8%, p < 0.001) and a shorter median time between the index MI and the diagnosis of shock (2.9 vs. 6.2 h, p = 0.003) in comparison to patients with LV shock. In-hospital mortality was 53.1% versus 60.8% (p = 0.296) for patients with predominant RV and LV shock, respectively, and the influence of revascularization on mortality was not different between groups. Multivariate analysis revealed that RV shock was not an independent predictor of lower in-hospital mortality (odds ratio 1.07, 95% confidence interval 0.54 to 2.13). CONCLUSIONS: Despite the younger age, lower rate of anterior MI, and higher prevalence of single-vessel coronary disease of RV compared with LV shock patients, and their similar benefit from revascularization, mortality is unexpectedly high in patients with predominant RV shock and similar to patients with LV shock.

Original languageEnglish (US)
Pages (from-to)1273-1279
Number of pages7
JournalJournal of the American College of Cardiology
Volume41
Issue number8
DOIs
StatePublished - Apr 2003
Externally publishedYes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Jacobs, A. K., Leopold, J. A., Bates, E., Mendes, L. A., Sleeper, L. A., White, H., Davidoff, R., Boland, J., Modur, S., Forman, R., & Hochman, J. S. (2003). Cardiogenic shock caused by right ventricular infarction: A report from the SHOCK registry. Journal of the American College of Cardiology, 41(8), 1273-1279. https://doi.org/10.1016/S0735-1097(03)00120-7