How to manage chronic total occlusions in the setting of acute myocardial infarction complicated by cardiogenic shock?
Bimmer E P M ClaessenRoxana MehranPublished in: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions (2019)
An observational study of 313 patients with multivessel disease and ST-segment elevation myocardial infarction complicated by cardiogenic shock showed that the presence of a chronic total occlusion (CTO) in a noninfarct-related artery is an independent predictor of short- and long-term mortality. This study confirms previous reports on the detrimental prognostic impact of a CTO in the setting of acute myocardial infarction with or without cardiogenic shock. Data from recent randomized trials (CULPRIT-SHOCK and EXPLORE) suggest no benefit of early CTO revascularization; further studies are needed to investigate early treatment with extracorporeal membrane oxygenation in this extremely high-risk subgroup.
Keyphrases
- percutaneous coronary intervention
- acute myocardial infarction
- st segment elevation myocardial infarction
- extracorporeal membrane oxygenation
- st elevation myocardial infarction
- coronary artery disease
- coronary artery bypass grafting
- acute coronary syndrome
- acute respiratory distress syndrome
- coronary artery bypass
- atrial fibrillation
- cardiovascular events
- respiratory failure
- electronic health record
- heart failure
- randomized controlled trial
- clinical trial
- type diabetes
- big data
- mechanical ventilation
- intensive care unit
- left ventricular
- cardiovascular disease
- risk factors
- case control
- replacement therapy