Current spectrum of cardiogenic shock and effect of early revascularization on mortality results of an international registry

Judith S. Hochman, Jean Boland, Lynn A. Sleeper, Mark Porway, Jeffrey A Brinker, Jacques Col, Alice Jacobs, James Slater, David Miller, Hal Wasserman, Mark A. Menegus, J. David Talley, Sonja McKinlay, Timothy Sanborn, Thierry LeJemtel

Research output: Contribution to journalArticle

Abstract

Background: Cardiogenic shock remains the leading cause of death of patients hospitalized with acute myocardial infarction (MI). This study was conducted to examine (1) the current spectrum of cardiogenic shock, (2) the proportion of patients who are potential candidates for a trial of early revascularization, and (3) the apparent impact of early revascularization on mortality. Methods and Results: Nineteen participating centers in the United States and Belgium prospectively registered all patients diagnosed with cardiogenic shock. Two hundred fifty-one patients were registered. The mean age was 67.5±11.7 years, and 43% were women. Acute mitral regurgitation or ventricular septal rupture was the cause of shock in 8%. Concurrent conditions contributing to the development of shock were noted in 5%, and 2% had isolated right ventricular shock. Among the remaining 214 patients, nonspecific findings on the ECG associated with "nontransmural" MI were seen in 14%. The median time to shock diagnosis after MI was 8 hours. The overall in-hospital mortality was 66%. Patients clinically selected to undergo cardiac catheterization were significantly younger and had a lower mortality than those not selected (51% versus 85%, P

Original languageEnglish (US)
Pages (from-to)873-881
Number of pages9
JournalCirculation
Volume91
Issue number3
Publication statusPublished - Feb 1 1995
Externally publishedYes

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Keywords

  • Angioplasty
  • Myocardial infarction
  • Revascularization
  • Shock

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Hochman, J. S., Boland, J., Sleeper, L. A., Porway, M., Brinker, J. A., Col, J., ... LeJemtel, T. (1995). Current spectrum of cardiogenic shock and effect of early revascularization on mortality results of an international registry. Circulation, 91(3), 873-881.