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Cardiogenic Shock

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1. Inotropic agents and vasodilator strategies for the treatment of cardiogenic shock or low cardiac output syndrome. (PubMed)

Inotropic agents and vasodilator strategies for the treatment of cardiogenic shock or low cardiac output syndrome. Cardiogenic shock (CS) and low cardiac output syndrome (LCOS) as complications of acute myocardial infarction (AMI), heart failure (HF) or cardiac surgery are life-threatening conditions. While there is a broad body of evidence for the treatment of people with acute coronary syndrome under stable haemodynamic conditions, the treatment strategies for people who become (...) 2017. We also searched four registers of ongoing trials and scanned reference lists and contacted experts in the field to obtain further information. No language restrictions were applied.Randomised controlled trials in people with myocardial infarction, heart failure or cardiac surgery complicated by cardiogenic shock or LCOS.We used standard methodological procedures expected by Cochrane.We identified 13 eligible studies with 2001 participants (mean or median age range 58 to 73 years) and two

2018 Cochrane

3. SCAI clinical expert consensus statement on the classification of cardiogenic shock

SCAI clinical expert consensus statement on the classification of cardiogenic shock SCAI clinical expert consensus statement on the classification of cardiogenic shock - Baran - - Catheterization and Cardiovascular Interventions - Wiley Online Library By continuing to browse this site, you agree to its use of cookies as described in our . Search within Search term Search term The full text of this article hosted at iucr.org is unavailable due to technical difficulties. VALVULAR AND STRUCTURAL (...) HEART DISEASES Free Access SCAI clinical expert consensus statement on the classification of cardiogenic shock This document was endorsed by the American College of Cardiology (ACC), the American Heart Association (AHA), the Society of Critical Care Medicine (SCCM), and the Society of Thoracic Surgeons (STS) in April 2019 Corresponding Author E-mail address: Sentara Heart Hospital, Division of Cardiology, Advanced Heart Failure Center and Eastern Virginia Medical School, Norfolk, Virginia

2019 Society for Cardiovascular Angiography and Interventions

4. The 4 Physiologic Etiologies of Shock, and the 3 Etiologies of Cardiogenic Shock

The 4 Physiologic Etiologies of Shock, and the 3 Etiologies of Cardiogenic Shock Dr. Smith's ECG Blog: The 4 Physiologic Etiologies of Shock, and the 3 Etiologies of Cardiogenic Shock Friday, November 30, 2018 A 60-something presented with hypotension, bradycardia, chest pain and back pain. She had a h/o aortic aneurysm, aortic insufficiency, peripheral vascular disease, and hypertension. She had a mechanical aortic valve. She was on anti-hypertensives including atenolol, and on coumadin (...) in aVR: Is this pattern specific for global ischemia due to left main coronary artery disease? J Electrocardiol 2013;46:240-8. Case continued: The chest X-ray was consistent with pulmonary edema, and the ultrasound showed a "plump" inferior vena cava. (This data is all consistent with high right and left sided filling pressures, which is the hallmark of cardiogenic shock -- not obstructive, distributive, or hypovolemic) Aortic dissection was considered (with involvement of the coronary arteries

2019 Dr Smith's ECG Blog

5. Impella CP (Abiomed) for use in adult patients with cardiogenic shock

Impella CP (Abiomed) for use in adult patients with cardiogenic shock Impella CP (Abiomed) for use in adult patients with cardiogenic shock Impella CP (Abiomed) for use in adult patients with cardiogenic shock HAYES, Inc Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation HAYES, Inc. Impella CP (Abiomed) for use in adult patients (...) with cardiogenic shock. Lansdale: HAYES, Inc. Healthcare Technology Brief Publication. 2017 Authors' conclusions Cardiogenic shock (CS) is an acute life-threatening condition resulting from inadequate blood circulation due to the inability of the heart (most often the left ventricle) to adequately meet systemic tissue demands for oxygen and nutrients. Technology Description: The Impella CP is an intravascular nonpulsatile axial blood pump designed to support the circulatory system during CS, low output

2018 Health Technology Assessment (HTA) Database.

6. Intraaortic Balloon Pump in Cardiogenic Shock Complicating Acute Myocardial Infarction: Long-Term 6-Year Outcome of the Randomized IABP-SHOCK II Trial

Intraaortic Balloon Pump in Cardiogenic Shock Complicating Acute Myocardial Infarction: Long-Term 6-Year Outcome of the Randomized IABP-SHOCK II Trial The role of intraaortic balloon counterpulsation (IABP) in cardiogenic shock is still a subject of intense debate despite the neutral results of the IABP-SHOCK II trial (Intraaortic Balloon Pump in Cardiogenic Shock II) with subsequent downgrading in international guidelines. So far, randomized data on the impact of IABP on long-term clinical (...) outcomes in patients with cardiogenic shock complicating acute myocardial infarction are lacking. Furthermore, only limited evidence is available on general long-term outcomes of patients with cardiogenic shock treated by contemporary practice.The IABP-SHOCK II trial is a multicenter, randomized, openlabel trial. Between 2009 and 2012, 600 patients with cardiogenic shock complicating acute myocardial infarction undergoing early revascularization were randomized to IABP versus control.Long-term follow

2019 EvidenceUpdates

7. Contemporary Management of Cardiogenic Shock: A Scientific Statement From the American Heart Association

Contemporary Management of Cardiogenic Shock: A Scientific Statement From the American Heart Association Contemporary Management of Cardiogenic Shock: A Scientific Statement From the American Heart Association | Circulation Search Hello Guest! Login to your account Email Password Keep me logged in Search March 2019 March 2019 March 2019 March 2019 March 2019 February 2019 February 2019 February 2019 February 2019 January 2019 January 2019 January 2019 January 2019 January 2019 This site uses (...) cookies. By continuing to browse this site you are agreeing to our use of cookies. Free Access article Share on Jump to Free Access article Contemporary Management of Cardiogenic Shock: A Scientific Statement From the American Heart Association , MD, MSc, FAHA, Chair , MD, MHS, Vice Chair , RN, PhD, FAHA , MD, FAHA , MD, FAHA , MD , MD , MD, FAHA , MD , MD, PhD, FAHA , MD , and PharmD, FAHA MDOn behalf of the American Heart Association Council on Clinical Cardiology; Council on Cardiovascular

2017 American Heart Association

8. Stent choice in cardiogenic shock complicating acute myocardial infarction likely does not affect mortality or reinfarction

Stent choice in cardiogenic shock complicating acute myocardial infarction likely does not affect mortality or reinfarction Stent choice in cardiogenic shock complicating acute myocardial infarction likely does not affect mortality or reinfarction | BMJ Evidence-Based Medicine We use cookies to improve our service and to tailor our content and advertising to you. You can manage your cookie settings via your browser at any time. To learn more about how we use cookies, please see our . Log (...) in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? Search for this keyword Search for this keyword Main menu Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? You are here Stent choice in cardiogenic shock complicating acute myocardial infarction likely does not affect mortality or reinfarction Article Text

2017 Evidence-Based Medicine (Requires free registration)

9. Mild Hypothermia in Cardiogenic Shock Complicating Myocardial Infarction

Mild Hypothermia in Cardiogenic Shock Complicating Myocardial Infarction Experimental trials suggest improved outcome by mild therapeutic hypothermia for cardiogenic shock after acute myocardial infarction. The objective of this study was to investigate the hemodynamic effects of mild therapeutic hypothermia in patients with cardiogenic shock complicating acute myocardial infarction.Patients (n=40) with cardiogenic shock undergoing primary percutaneous coronary intervention without classic (...) hypothermia failed to show a substantial beneficial effect on cardiac power index at 24 hours in patients with cardiogenic shock after acute myocardial infarction.URL: https://www.clinicaltrials.gov . Unique identifier: NCT01890317.

2019 EvidenceUpdates

10. Cangrelor in Cardiogenic Shock and after Cardiopulmonary Resuscitation: A Global, Multicenter, Matched Pair Analysis with Oral P2Y<sub>12</sub> Inhibition from the IABP-SHOCK II Trial. (PubMed)

Cangrelor in Cardiogenic Shock and after Cardiopulmonary Resuscitation: A Global, Multicenter, Matched Pair Analysis with Oral P2Y12 Inhibition from the IABP-SHOCK II Trial. Cangrelor has a potentially favorable pharmacodynamic profile in cardiogenic shock (CS). We aimed to evaluate the clinical course of CS patients undergoing percutaneous coronary intervention (PCI) treated with cangrelor.We retrospectively identified 136 CS patients treated with cangrelor. Patients were 1:1 (...) matched to CS patients from the IABP-SHOCK II trial not receiving cangrelor by age, sex, cardiac arrest, type of myocardial infarction, culprit lesion, glycoprotein IIb/IIIa inhibitor, and oral P2Y12-receptor inhibitor and followed-up for 12 months. The study cohort consisted of 88 matched pairs. Thirty-day and 12-month mortality was 29.5% and 34.1% in cangrelor-treated patients and 36.4% and 47.1% in control group (P = 0.34 and P = 0.08, respectively). The rate of definite acute stent thrombosis

2019 Resuscitation

11. Rationale and design of DanGer shock: Danish-German cardiogenic shock trial. (PubMed)

Rationale and design of DanGer shock: Danish-German cardiogenic shock trial. The DanGer Shock trial test the hypothesis that left ventricular (LV) mechanical circulatory support with Impella CP transvalvular microaxial flow pump improves survival in patients with ST segment elevation acute myocardial infarction complicated by cardiogenic shock (AMICS) compared to conventional guideline-driven treatment. This paper describes the rationale and design of the randomized trial, in addition (...) 10%-30%).The DanGer Shock trial will be the first adequately powered randomized trial to address whether mechanical circulatory LV support with Impella CP can improve survival in AMICS. Baseline characteristics of the first 100 randomized patients indicate a population in profound cardiogenic shock.Copyright © 2019 The Author(s). Published by Elsevier Inc. All rights reserved.

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2019 American Heart Journal

12. Acute heart failure following myocardial infarction: complement activation correlates with the severity of heart failure in patients developing cardiogenic shock (PubMed)

Acute heart failure following myocardial infarction: complement activation correlates with the severity of heart failure in patients developing cardiogenic shock Heart failure (HF) is an impending complication to myocardial infarction. We hypothesized that the degree of complement activation reflects severity of HF following acute myocardial infarction.The LEAF trial (LEvosimendan in Acute heart Failure following myocardial infarction) evaluating 61 patients developing HF within 48 h after (...) percutaneous coronary intervention-treated ST-elevation myocardial infarction herein underwent a post hoc analysis. Blood samples were drawn from inclusion to Day 5 and at 42 day follow-up, and biomarkers were measured with enzyme immunoassays. Regional myocardial contractility was measured by echocardiography as wall motion score index (WMSI). The cardiogenic shock group (n = 9) was compared with the non-shock group (n = 52). Controls (n = 44) were age-matched and sex-matched healthy individuals. C4bc

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2018 ESC heart failure

13. Cardiogenic Shock after Nifedipine Administration in a Pregnant Patient: A Case Report and Review of the Literature (PubMed)

Cardiogenic Shock after Nifedipine Administration in a Pregnant Patient: A Case Report and Review of the Literature We present a case of a 21-year-old Caucasian woman at 27 weeks of pregnancy who was admitted to the obstetric department for pre-term labor. She received 10 mg of nifedipine 4 times in 1 h, according to the internal protocol. Shortly after, she brutally deteriorated with pulmonary edema and hypoxemia requiring transfer to the intensive care unit (ICU) for mechanical ventilation (...) . She finally improved and was successfully extubated after undergoing a percutaneous valvuloplasty of the mitral valve. This case illustrates a severe cardiogenic shock after administration of nifedipine for premature labor in a context of unknown rheumatic mitral stenosis. Nifedipine induces a reflex tachycardia that reduces the diastolic period and thereby precipitates pulmonary edema in case of mitral stenosis. This case emphasizes the fact that this drug may be severely harmful and should never

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2018 Journal of translational internal medicine

14. An elderly man with sudden cardiogenic shock, diffuse ST depressions, and STE in aVR

An elderly man with sudden cardiogenic shock, diffuse ST depressions, and STE in aVR Dr. Smith's ECG Blog: An elderly man with sudden cardiogenic shock, diffuse ST depressions, and STE in aVR Wednesday, October 31, 2018 Written by Pendell Meyers 84 yo M with history of a “valve problem” presented for sudden onset chest pain and trouble breathing while eating lunch. He was sitting bolt upright, diaphoretic, tachypneic, with bilateral crackles. Although his BP was 126/84, he was in acute (...) cardiogenic shock. Here is his initial ECG: Sinus tach with occasional PACs. Relatively normal QRS complex with diffuse significant ST depression including leads V2-V6, I, aVL, II, III, and aVF, with ST elevation in aVR. The vector of ST depression is maximal in leads V5 and II, consistent with diffuse subendocardial ischemia. There is no evidence of any single vessel OMI (Occlusion MI). This is not consistent with posterior OMI, which would have ST depression maximal in V2-V4 usually without diffuse ST

2018 Dr Smith's ECG Blog

15. Clinical outcomes of second-generation limus-eluting stents compared to paclitaxel-eluting stents for acute myocardial infarction with cardiogenic shock. (PubMed)

Clinical outcomes of second-generation limus-eluting stents compared to paclitaxel-eluting stents for acute myocardial infarction with cardiogenic shock. Whether the cardiovascular (CV) outcomes of second-generation limus-eluting stents (LESs) differ from those of paclitaxel-eluting stents (PESs) in patients with acute myocardial infarction (AMI) complicated by cardiogenic shock (CS) is still unclear.We used the Taiwan National Health Insurance Research Database to analyse data of 516 patients

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2019 PLoS ONE

16. Hypoalbuminemia is a frequent marker of increased mortality in cardiogenic shock. (PubMed)

Hypoalbuminemia is a frequent marker of increased mortality in cardiogenic shock. The prevalence of hypoalbuminemia, early changes of plasma albumin (P-Alb) levels, and their effects on mortality in cardiogenic shock are unknown.P-Alb was measured from serial blood samples in 178 patients from a prospective multinational study on cardiogenic shock. The association of hypoalbuminemia with clinical characteristics and course of hospital stay including treatment and procedures was assessed (...) . The primary outcome was all-cause 90-day mortality.Hypoalbuminemia (P-Alb < 34g/L) was very frequent (75%) at baseline in patients with cardiogenic shock. Patients with hypoalbuminemia had higher mortality than patients with normal albumin levels (48% vs. 23%, p = 0.004). Odds ratio for death at 90 days was 2.4 [95% CI 1.5-4.1] per 10 g/L decrease in baseline P-Alb. The association with increased mortality remained independent in regression models adjusted for clinical risk scores developed

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2019 PLoS ONE

17. Meta-analysis Comparing Complete or Culprit Only Revascularization in Patients With Multivessel Disease Presenting With Cardiogenic Shock

Meta-analysis Comparing Complete or Culprit Only Revascularization in Patients With Multivessel Disease Presenting With Cardiogenic Shock The optimal strategy for patients with an acute myocardial infarction (MI) and multivessel (MV) coronary artery disease complicated by cardiogenic shock (CS) remains unknown. We conducted a meta-analysis of all randomized controlled trials and observational studies that reported adjusted effect measures to evaluate the association of MV-PCI (percutaneous

2018 EvidenceUpdates

18. Meta-Analysis and Trial Sequential Analysis Comparing Percutaneous Ventricular Assist Devices Versus Intra-Aortic Balloon Pump During High-Risk Percutaneous Coronary Intervention or Cardiogenic Shock

Meta-Analysis and Trial Sequential Analysis Comparing Percutaneous Ventricular Assist Devices Versus Intra-Aortic Balloon Pump During High-Risk Percutaneous Coronary Intervention or Cardiogenic Shock The intra-aortic balloon pump (IABP) and percutaneous ventricular assist devices (pVAD) are commonly used in different clinical scenarios. The goal of this study was to carry out a meta-analysis and Trial Sequential Analysis (TSA) comparing the IABP versus pVAD (TandemHeart and the Impella) during (...) high-risk percutaneous coronary intervention (PCI) or cardiogenic shock (CS). Using PubMed, Cochrane Central Register of Controlled Trials, and EMBASE we searched for randomized clinical trials (RCTs) and nonrandomized studies that compared pVAD versus IABP in patients who underwent high-risk PCI or with CS. We included 5 RCTs and 1 nonrandomized study comparing pVAD versus IABP. Based on the RCTs, we demonstrated no difference in short-term (6 months) (risk ratio [RR] 1.09, 95% confidence interval

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2018 EvidenceUpdates

19. Inotropic agents and vasodilator strategies for acute myocardial infarction complicated by cardiogenic shock or low cardiac output syndrome. (PubMed)

Inotropic agents and vasodilator strategies for acute myocardial infarction complicated by cardiogenic shock or low cardiac output syndrome. The recently published German-Austrian S3 Guideline for the treatment of infarct related cardiogenic shock (CS) revealed a lack of evidence for all recommended therapeutic measures.To determine the effects in terms of efficacy, efficiency and safety of cardiac care with inotropic agents and vasodilator strategies versus placebo or against each other

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2014 Cochrane

20. Epinephrine Versus Norepinephrine for Cardiogenic Shock After Acute Myocardial Infarction

Epinephrine Versus Norepinephrine for Cardiogenic Shock After Acute Myocardial Infarction Vasopressor agents could have certain specific effects in patients with cardiogenic shock (CS) after myocardial infarction, which may influence outcome. Although norepinephrine and epinephrine are currently the most commonly used agents, no randomized trial has compared their effects, and intervention data are lacking.The goal of this paper was to compare in a prospective, double-blind, multicenter (...) compared with norepinephrine, including an increase in cardiac double product (p = 0.0002) and lactic acidosis from H2 to H24 (p < 0.0001).In patients with CS secondary to acute myocardial infarction, the use of epinephrine compared with norepinephrine was associated with similar effects on arterial pressure and cardiac index and a higher incidence of refractory shock. (Study Comparing the Efficacy and Tolerability of Epinephrine and Norepinephrine in Cardiogenic Shock [OptimaCC]; NCT01367743

2018 EvidenceUpdates

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