Journal ArticleDOI
Effect of Early Initiation of Mechanical Circulatory Support on Survival in Cardiogenic Shock
Mir B Basir,Theodore Schreiber,Cindy L. Grines,Simon R. Dixon,Jeffrey W. Moses,Brijeshwar Maini,Akshay Khandelwal,E. Magnus Ohman,William W. O'Neill +8 more
TLDR
MCS implantation early after shock onset, before initiation of inotropes or vasopressors and before PCI, is independently associated with improved survival in patients presenting with AMICS.Abstract:
The role and timing of percutaneous mechanical circulatory support (MCS) devices in the treatment of acute myocardial infarction complicated by cardiogenic shock (AMICS) are not well understood. We sought to evaluate patient characteristics and predictors of outcomes in patients presenting with AMICS supported with an axial flow percutaneous MCS device; 287 consecutive unselected patients enrolled in the catheter-based ventricular assist device registry presenting with AMICS who underwent percutaneous coronary intervention (PCI) were included in this analysis. All patients were supported with either the Impella 2.5 or Impella CP. Mean patient age was 66 ± 12.5 years, 76% were men, and mean left ventricular ejection fraction was 25 ± 12%. Before receiving MCS, 80% of patients required inotropes or vasopressors and 40% were supported with intra-aortic balloon pump; 9% of patients were under active cardiopulmonary resuscitation at the time of MCS implantation. Survival to discharge was 44%. In a multivariate analysis, early implantation of a MCS device before PCI (p = 0.04) and before requiring inotropes and vasopressors (p = 0.05) was associated with increased survival. Survival was 66% when MCS was initiatedread more
Citations
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Journal ArticleDOI
2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.
Paul A. Heidenreich,Biykem Bozkurt,David Aguilar,Larry A. Allen,Joni J. Byun,Monica Colvin,Anita Deswal,Mark H. Drazner,Shannon M. Dunlay,Linda R. Evers,James C. Fang,Savitri Fedson,Gregg C. Fonarow,Salim S. Hayek,Adrian F. Hernandez,Prateeti Khazanie,Michelle M. Kittleson,Christopher S. Lee,Mark S. Link,Carmelo A. Milano,Lorraine C. Nnacheta,Alexander T. Sandhu,Lynne W. Stevenson,Orly Vardeny,Amanda R. Vest,Clyde W. Yancy +25 more
TL;DR: The "2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure" as discussed by the authors provides patient-centric recommendations for clinicians to prevent, diagnose, and manage patients with heart failure.
Journal ArticleDOI
2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines
TL;DR: The 2022 guideline as discussed by the authors provides patient-centric recommendations for clinicians to prevent, diagnose, and manage patients with heart failure, with the intent to improve quality of care and align with patients' interests.
Journal ArticleDOI
2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.
Paul A. Heidenreich,Biykem Bozkurt,David Aguilar,Larry A. Allen,Joni J. Byun,Monica Colvin,Anita Deswal,Mark H. Drazner,Shannon M. Dunlay,Linda R. Evers,James C. Fang,Savitri Fedson,Gregg C. Fonarow,Salim S. Hayek,Adrian F. Hernandez,Prateeti Khazanie,Michelle M. Kittleson,Christopher S. Lee,Mark S. Link,Carmelo A. Milano,Lorraine C. Nnacheta,Alexander T. Sandhu,Lynne W. Stevenson,Orly Vardeny,Amanda R. Vest,Clyde W. Yancy +25 more
TL;DR: The 2022 heart failure guideline provides recommendations based on contemporary evidence for the treatment of patients with heart failure, with the intent to improve quality of care and align with patients' interests.
Journal ArticleDOI
Intraaortic balloon support for myocardial infarction with cardiogenic shock
Journal ArticleDOI
Impella Support for Acute Myocardial Infarction Complicated by Cardiogenic Shock.
Benedikt Schrage,Karim Ibrahim,Tobias Loehn,Nikos Werner,Jan Malte Sinning,Federico Pappalardo,Marina Pieri,Carsten Skurk,Alexander Lauten,Ulf Landmesser,Ralf Westenfeld,Patrick Horn,Matthias Pauschinger,Dennis Eckner,Raphael Twerenbold,Peter Nordbeck,Tim Salinger,Peter Abel,Klaus Empen,Mathias Busch,Stephan B. Felix,Jan Thorben Sieweke,Jacob E. Møller,Nilesh Pareek,Jonathan Hill,Philip MacCarthy,Martin Bergmann,José P.S. Henriques,Sven Möbius-Winkler,P. Christian Schulze,Taoufik Ouarrak,Uwe Zeymer,Steffen Schneider,Stefan Blankenberg,Holger Thiele,Andreas Schäfer,Dirk Westermann +36 more
TL;DR: In this retrospective analysis of patients with AMI-CS, the use of an Impella device was not associated with lower 30-day mortality compared with matched patients from the IABP-SHOCK II trial treated with an IABp or medical therapy.
References
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Journal ArticleDOI
2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction
Patrick T. O'Gara,Frederick G. Kushner,Deborah D. Ascheim,Donald E. Casey,Mina K. Chung,James A. de Lemos,Steven M. Ettinger,James C. Fang,Francis M. Fesmire,Barry A. Franklin,Christopher B. Granger,Harlan M. Krumholz,Jane A. Linderbaum,David A. Morrow,L. Kristin Newby,Joseph P. Ornato,Narith N. Ou,Martha J. Radford,Jacqueline E. Tamis-Holland,Carl L. Tommaso,Cynthia M. Tracy,Y. Joseph Woo,David Zhao +22 more
TL;DR: The 2017-18 FAHA/FACC/FAHA Education and Research Grants will be focused on advancing the profession’s understanding of central nervous system disorders and the management of post-traumatic stress disorder.
Journal ArticleDOI
Early Revascularization in Acute Myocardial Infarction Complicated by Cardiogenic Shock
Js. Hochman,La. Sleeper,John G. Webb,Timothy A. Sanborn,Harvey D. White,JD Talley,Christopher E. Buller,Alice K. Jacobs,James Slater,Jacques Col,Sonja M. McKinlay,Thierry H. LeJemtel +11 more
TL;DR: In patients with cardiogenic shock, emergency revascularization did not significantly reduce overall mortality at 30 days, but after six months there was a significant survival benefit, and earlyRevascularization should be strongly considered for patients with acute myocardial infarction complicated by cardiogenesis.
Journal ArticleDOI
Intraaortic Balloon Support for Myocardial Infarction with Cardiogenic Shock
Holger Thiele,Uwe Zeymer,Franz-Josef Neumann,Miroslaw Ferenc,Hans-Georg Olbrich,Jörg Hausleiter,Gert Richardt,Marcus Hennersdorf,Klaus Empen,Georg Fuernau,Steffen Desch,Ingo Eitel,Rainer Hambrecht,Jörg Fuhrmann,Michael Böhm,Henning Ebelt,Steffen Schneider,Gerhard Schuler,Karl Werdan +18 more
TL;DR: The use of intraaortic balloon counterpulsation did not significantly reduce 30-day mortality in patients with cardiogenic shock complicating acute myocardial infarction for whom an early revascularization strategy was planned.
Journal ArticleDOI
A Randomized Clinical Trial to Evaluate the Safety and Efficacy of a Percutaneous Left Ventricular Assist Device Versus Intra-Aortic Balloon Pumping for Treatment of Cardiogenic Shock Caused by Myocardial Infarction
Melchior Seyfarth,Dirk Sibbing,Iris Bauer,Georg M. Fröhlich,Lorenz Bott-Flügel,Robert A. Byrne,Josef Dirschinger,Adnan Kastrati,Albert Schömig +8 more
TL;DR: In patients presenting with cardiogenic shock caused by AMI, the use of a percutaneously placed LVAD (Impella LP 2.5) is feasible and safe, and provides superior hemodynamic support compared with standard treatment using an intra-aortic balloon pump.
Journal ArticleDOI
Cardiogenic Shock Complicating Acute Myocardial Infarction—Etiologies, Management and Outcome: A Report from the SHOCK Trial Registry
Judith S. Hochman,Christopher E. Buller,Lynn A. Sleeper,Jean Boland,Vladimir Dzavik,Timothy A. Sanborn,Emilie Godfrey,Harvey D. White,John Lim,Thierry H. LeJemtel +9 more
TL;DR: The similarity of the beneficial treatment effect in patients undergoing early revascularization in the SHOCK Trial Registry and SHocks Trial provides strong support for the generalizability of the SHock Trial results.