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Organized by
Nanjing Heart Center
Asian Bifurcation Club (ABC)
Nanjing First Hospital, Nanjing Medical University
Co-organized by
Chinese Society of Cardiology (CSC)
Capacity Building and Continuing Education Center,National Health and Family Planning Commission (CBCEC)
American Society for Cardiovascular Angiography and Interventions (SCAI)
Asian Heart Society (AHS)
Contact Us
Registration Administration of Domestic Representatives
Hongjuan Peng :
+86-13913895477
Haimei Xu +86-13914736846
cbsnj@cbsmd.cn
Registration Administration of Overseas Representatives
Ling Lin : +86 (25) 52271398
+86-13951884596
cbs@cbsmd.cn
Management of Challenging Cases
Yingying Zhao :+86-13815408517
sub@cbsmd.cn
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210006
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Recommended Paper
Management of Acute Myocardial Infarction During the COVID-19 Pandemic
COVID-19 and Thrombotic or Thromboembolic Disease: Implications for Prevention, Antithrombotic Therapy, and Follow-up
CSC Expert Consensus on Principles of Clinical Management of Patients with Severe Emergent Cardiovascular Diseases during the COVID-19 Epidemic
ACC Clinical Bulletin Focuses on Cardiac Implications of Coronavirus (COVID-19)
Acute Coronary Syndrom
Original Research2017 Oct;6(7):601-609.
JOURNAL：Eur Heart J Acute Cardiovasc Care. Article Link
Zeymer U, Werdan K, Thiele H et al. Keywords: multivessel percutaneous coronary intervention; cardiogenic shock; culprit artery; mortality; myocardial infarction; IABP-SHOCK II trial
BACKGROUND - Current guidelines recommend immediate multivessel percutaneous coronary intervention (PCI) in patients with cardiogenic shock, despite the lack of randomised trials. We sought to investigate the use and impact on outcome of multivessel PCI in comparison to culprit lesion only PCI in a retrospective analysis in patients with cardiogenic shock complicating acute myocardial infarction.
METHODS AND RESULTS - In the randomised IABP-SHOCK II trial, investigating the effect of intra-aortic balloon pump on outcome, 451 (75%) of the total of 600 patients had multivessel coronary artery disease and underwent PCI. Immediate multivessel PCI was performed in 167 (37%) patients. TIMI 3 patency after PCI in all treated vessels was observed in 83.2% versus 79.0% of patients after multivessel versus culprit lesion PCI, respectively. The 30-day (44.9% vs. 42.3%) and 12-month (54.8% vs. 52.7%) mortality rates did not significantly differ between the two groups. In the multivariate analysis multivessel PCI was not associated with an improved mortality after 12 months (odds ratio 0.92, 95% confidence intervals 0.69-1.21).
CONCLUSION - In this retrospective analysis of the largest randomised study in cardiogenic shock immediate multivessel PCI was used in approximately one third of patients with cardiogenic shock. There was no benefit with immediate multivessel PCI in comparison to culprit lesion only PCI. Therefore a randomised trial is needed to determine the definitive role of multivessel PCI in cardiogenic shock.
CLINICAL TRIAL REGISTRATION - ClinicalTrials.gov , NCT00491036.
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