We have located links that may give you full text access.
JOURNAL ARTICLE
REVIEW
Revascularization strategies in cardiogenic shock after acute myocardial infarction.
Current Opinion in Critical Care 2019 August
PURPOSE OF REVIEW: Coronary revascularization compared with medical treatment alone leads to improved survival in patients with myocardial infarction (MI) and cardiogenic shock. Percutaneous coronary intervention (PCI) is the predominant mode of revascularization in clinical practice. This review discusses several aspects relevant to mechanical revascularization such as general indication, the roles of PCI and bypass surgery, percutaneous access site choice, strategy in multivessel disease and adjunctive antithrombotic therapy.
RECENT FINDINGS: The recently published CULPRIT-SHOCK trial provided the first randomized evidence that in the vast majority of patients with infarct-related cardiogenic shock PCI should be confined to the culprit lesion, whereas nonculprit lesions should not be routinely treated in the emergency setting. Although randomized data are not available, a primary radial access for PCI is becoming more popular in the shock population. Cardiac surgery plays an indispensable, yet quantitatively only minor role in the management of infarct-related cardiogenic shock.
SUMMARY: Coronary revascularization remains the cornerstone in the early management of patients with acute MI and cardiogenic shock. In patients with multivessel disease, a strategy of culprit lesion only PCI is the default approach.
RECENT FINDINGS: The recently published CULPRIT-SHOCK trial provided the first randomized evidence that in the vast majority of patients with infarct-related cardiogenic shock PCI should be confined to the culprit lesion, whereas nonculprit lesions should not be routinely treated in the emergency setting. Although randomized data are not available, a primary radial access for PCI is becoming more popular in the shock population. Cardiac surgery plays an indispensable, yet quantitatively only minor role in the management of infarct-related cardiogenic shock.
SUMMARY: Coronary revascularization remains the cornerstone in the early management of patients with acute MI and cardiogenic shock. In patients with multivessel disease, a strategy of culprit lesion only PCI is the default approach.
Full text links
Related Resources
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app