Tag: Acute Myocardial Infarction


Complications Management: Hemolysis in AMI Complicated by Cardiogenic Shock

Dr. Jeffrey Fowler of the University of Pittsburg Medical Center presents a case describing a patient who had been in the CCU for 8 hours before experiencing an output of pink-tinged urine. Dr. Fowler was paged with concerns about the patient’s risk for hemolysis. Tune in to learn more about Dr. Fowler’s management strategy for … Continue reading “Complications Management: Hemolysis in AMI Complicated by Cardiogenic Shock”

IMPRESS in Severe Shock Trial: Looking Closer at the Data

For patients with cardiogenic shock (CS), intra-aortic balloon pump (IABP) had been an important tool for maintaining patients and improving survival after percutaneous coronary intervention (PCI). Randomized controlled trials, however, have found very little evidence to support the notion that IABP is helpful for reducing mortality or improving hemodynamics for patients with CS.1,2 The Impella® … Continue reading “IMPRESS in Severe Shock Trial: Looking Closer at the Data”

Mortality Remains High for STEMI Patients Complicated by Cardiogenic Shock

Key Takeaways

  • Early reperfusion for STEMI patients complicated by cardiogenic shock results in lower mortality compared to prolonged reperfusion.
  • Shorter onset-to-balloon (OTB) and door-to-balloon (DTB) times are recommended to improve patient survival.
  • A shorter OTB was associated with longer overall survival in patients vs prolonged OTB (43.3% and 55.5%, respectively).
  • Mortality rates for short vs long DTB in this study were 44.9% and 55.8%, respectively.
The significant reduction of in-hospital mortality related to ST-segment elevation acute myocardial infarction (STEMI) has been greatly attributed to the overwhelming adoption of primary percutaneous intervention (PCI). STEMI patients with cardiogenic shock (CS) tend to experience a higher mortality even after PCI and the implantation of mechanical circulatory support (MCS) devices.A recent retrospective study published in European Heart Journal: Acute Cardiovascular Care assessed the mortality benefit, if any, of reperfusion via primary PCI for patients with STEMI complicated with CS of 466 patients enrolled in the Coronary Revascularization Demonstrating Outcome Study in Kyoto (CREDO-Kyoto) acute myocardial infarction (AMI) registry. Continue readingMortality Remains High for STEMI Patients Complicated by Cardiogenic Shock

Women With Cardiogenic Shock Derive Greater Benefit From Impella 2.5

The aim of this recent cVAD Registry analysis was to assess survival differences between men and women supported with Impella 2.5 in the setting of acute myocardial infarction (AMI) complicated by cardiogenic shock (CS). The article concludes that early initiation of hemodynamic support prior to PCI with Impella 2.5, in the setting of AMI complicated by CS, was associated with a greater survival benefit to hospital discharge in women compared to men. This despite a higher predicted risk of mortality and a greater revascularization failure rate for women.
Continue readingWomen With Cardiogenic Shock Derive Greater Benefit From Impella 2.5