New insights into cardiogenic shock and coronary revascularization after acute myocardial infarction

被引:13
作者
Gerbaud, Edouard [1 ,2 ]
Elbaz, Meyer [3 ]
Lattuca, Benoit [4 ]
机构
[1] Hop Cardiol Haut Leveque, Cardiol Intens Care Unit & Intervent Cardiol, F-33600 Pessac, France
[2] Bordeaux Univ, Bordeaux Cardiothorac Res Ctr, U1045, F-33000 Bordeaux, France
[3] Univ Paul Sabatier, Rangueil Med Sch, CARDIOMET Inst, Dept Cardiol, F-31059 Toulouse, France
[4] Montpellier Univ, Caremeau Univ Hosp, Cardiol Dept, ACTION Study Grp, F-30029 Nimes, France
关键词
Cardiogenic shock; Acute myocardial infarction; Coronary revascularization; Cardiac shock centre; EXTRACORPOREAL MEMBRANE-OXYGENATION; INTRAAORTIC BALLOON PUMP; THERAPEUTIC HYPOTHERMIA; ELDERLY-PATIENTS; ST-ELEVATION; OCCLUDED CORONARIES; CLINICAL-OUTCOMES; TEMPORAL TRENDS; CULPRIT LESION; PRIMARY PCI;
D O I
10.1016/j.acvd.2019.12.005
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Cardiogenic shock complicating acute myocardial infarction is challenging, and continues to be associated with high rates of in-hospital and long-term mortality. Coronary revascularization is critical for improving prognosis in CS. Thus, a systematic protocol-driven approach to cardiogenic shock, the development of specialized cardiac care centres, technical advances in interventional cardiology enabling treatment of more complex and severe lesions, the availability of recent antithrombotic therapies and the evolution of new haemodynamic support devices are important considerations in current management of cardiogenic shock complicating acute ischaemic heart disease. Despite these potentially meaningful developments, several substantial gaps in knowledge still exist regarding optimal coronary revascularization of patients with cardiogenic shock. This review will describe current principles in the revascularization of these patients, with a focus on: the time to transfer and revascularize; the choice of vascular access site; the need for complete revascularization or only a culprit lesion strategy; the optimal antithrombotic therapy; the type, place and timing of haemodynamic support; and the medical care system network. (C) 2020 Elsevier Masson SAS. All rights reserved.
引用
收藏
页码:276 / 284
页数:9
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