The Official Journal of EuroPCR and the European Association of Percutaneous Coronary Interventions (EAPCI)

EDITORIAL

Acute myocardial infarction, chronic total occlusion, and cardiogenic shock: the ultimate triple threat

EuroIntervention 2018;14:e252-e254 published online e-edition June 2018. DOI: 10.4244/EIJV14I3A42

1. Department of Cardiology, Academic Medical Center - University of Amsterdam, Amsterdam, the Netherlands; 2. Department of Cardiology, Mount Sinai Hospital, New York, NY, USA


Even today, ST-segment elevation myocardial infarction (STEMI) complicated by cardiogenic shock (CS) remains associated with very high mortality1,2. There is currently only one positive randomised clinical trial in the setting of STEMI complicated by CS - the SHOCK (Should We Emergently Revascularize Occluded Coronaries for Cardiogenic Shock) trial - which showed a reduction in mortality with emergency revascularisation compared with initial medical stabilisation in CS patients3. Ever since SHOCK was published 20 years ago mortality rates in CS have remained stable at approximately 50%1-3. Multivessel disease is very common in patients with CS, with a prevalence of approximately 80%1. Prior observational ...

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