ABSTRACT
Despite advances over the past decade, the incidence of cardiogenic
shock secondary to acute myocardial infarction has increased, with an
unchanged mortality near 50%. Recent trials have not clarified the best
strategies in treatment. While dedicated cardiac shock centers are being
established, there are no standardized agreements on the utilization
of mechanical circulatory support and the timeliness of percutaneous
coronary intervention strategies. In some centers and prospective
registries, outcomes after placement of advanced mechanical circulatory
support prior to reperfusion therapy with percutaneous coronary
intervention have been encouraging with improved survival. Here, we
suggest systems of care with a treatment pathway for patients with acute
myocardial infarction complicated by cardiogenic shock.