Summary
This prospective multicenter study of 171 patients with acute myocardial infarction and cardiogenic shock evaluated outcomes associated with a standardised shock protocol emphasising early mechanical circulatory support and invasive haemodynamic monitoring. Overall survival to discharge was 72%. The study identified elevated creatinine, elevated lactate, reduced cardiac power output, and advanced age as independent predictors of mortality, with lactate and cardiac power output measurements at 12–24 hours providing reliable prognostic value. The findings suggest that protocolised management of cardiogenic shock improves contemporary outcomes.
UK applicability
The findings are applicable to UK cardiology practice, as the study demonstrates a transferable protocolised approach to acute cardiogenic shock management that could inform similar standardised protocols in UK cardiac centres. However, outcomes may vary depending on local resources, expertise with mechanical circulatory support devices, and healthcare system factors.
Key measures
Survival to discharge (primary outcome); creatinine ≥2 mg/dL, lactate >4 mmol/L, cardiac power output <0.6 W, age ≥70 years (mortality predictors); door-to-support time and door-to-balloon time; lactate and cardiac power output measurements at 12–24 hours post-procedure
Outcomes reported
The study measured survival to discharge and identified predictors of mortality in acute myocardial infarction patients with cardiogenic shock treated with early mechanical circulatory support. Clinical parameters including creatinine, lactate, cardiac power output, and age were assessed as mortality predictors.
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