Cardiogenic shock in the course of myocardial infarction--the results of treatment during hospitalization and in long-term follow-up

• Published in: Wiadomości lekarskie (1960) Vol. 56; no. 1-2; p. 4
• Main Authors: Gasior, Mariusz, Wasilewski, Jarosław, Gierlotka, Marek, Zebik, Tadeusz, Szkodziński, Janusz, Kondys, Marek, Lekston, Andrzej, Wilczek, Krzysztof, Wojnar, Rafał, Wnek, Andrzej, Wojnicz, Romuald, Szyguła, Bozena, Adamowicz, Elzbieta, Zembala, Marian, Poloński, Lech
• Format: Journal Article
• Language: Polish
• Published: Poland 2003
• Subjects: Aged; Angioplasty, Balloon, Coronary; Coronary Angiography; Female; Fibrinolytic Agents - therapeutic use; Follow-Up Studies; Hospital Mortality; Humans; Male; Middle Aged; Myocardial Infarction - complications; Myocardial Infarction - therapy; Retrospective Studies; Shock, Cardiogenic - etiology; Shock, Cardiogenic - mortality; Shock, Cardiogenic - therapy; Streptokinase - therapeutic use; Survival Analysis; Time Factors; Treatment Outcome
• ISSN: 0043-5147

Cardiogenic shock develops in 5-15% of patients hospitalised with acute myocardial infarction. It is responsible for more than a half of all hospital deaths with survival rate of about 20%. Conventional medical therapy with use of adrenergic, vasoactive, inotropic and thrombolytic agents has failed to improve survival. Treatment strategy combine hemodynamic stabilisation with restoration of coronary blood flow. The aim of the study was evaluation of mechanical restoration of coronary blood flow in infarction related artery and to assess its influence on mortality in patients with myocardial infarction complicated by cardiogenic shock. We retrospectively analysed 58 subjects: 26 patients treated by primary angioplasty, 25 patients with PTCA angioplasty after streptokinase treatment and 7 ones treated conservatively. TIMI 3 flow in angioplasty treated patients was achieved in 70.6% with in hospital mortality rate 14%, however, when reperfusion was unsuccessful the mortality was high (80%). 12 months follow-up mortality rate was 41.8%.
Successful reperfusion with coronary angioplasty of the infarct-related artery can significantly reduce mortality rate in patients with cardiogenic shock. Patients who survived in-hospital period have favourable one-year prognosis.