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Cardiogenic Shock

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61. Outcomes Among Patients Transferred for Revascularization With Impella for Acute Myocardial Infarction With Cardiogenic Shock from the cVAD Registry. (Abstract)

Outcomes Among Patients Transferred for Revascularization With Impella for Acute Myocardial Infarction With Cardiogenic Shock from the cVAD Registry. The outcomes for patients transferred with cardiogenic shock and later treated with revascularization and Impella support have not previously been studied. To evaluate these outcomes, patients in cardiogenic shock were recruited from the catheter-based ventricular assist device registry, a prospective registry enrolling patients who underwent (...) percutaneous coronary intervention with hemodynamic support using Impella 2.5 or CP. Analysis was performed on subgroups of patients who were characterized as those directly admitted to a tertiary care hospital (direct), or those transferred from an outside hospital (transfer). Patients who were transferred with acute myocardial infarction with cardiogenic shock (AMICS) more often presented in shock were in shock longer than 24 hours, and were more likely to be on intra-aortic balloon pump but were less

2019 American Journal of Cardiology

62. Axillary Artery Access for Mechanical Circulatory Support Devices in Patients With Prohibitive Peripheral Arterial Disease Presenting With Cardiogenic Shock. (Abstract)

Axillary Artery Access for Mechanical Circulatory Support Devices in Patients With Prohibitive Peripheral Arterial Disease Presenting With Cardiogenic Shock. In patients with severe peripheral vascular disease, the common femoral artery may be so diseased as to not allow for deployment of mechanical circulatory support (MCS) such as in the setting of cardiogenic shock (CS). We sought to study the feasibility of axillary artery as alternative access for MCS in CS patients with severe occlusive

2019 American Journal of Cardiology

63. Blood Lactate as a Reliable Marker for Mortality of Pediatric Refractory Cardiogenic Shock Requiring Extracorporeal Membrane Oxygenation. (Abstract)

Blood Lactate as a Reliable Marker for Mortality of Pediatric Refractory Cardiogenic Shock Requiring Extracorporeal Membrane Oxygenation. The objective of this study is to establish reliable markers for mortality in children with refractory cardiogenic shock who underwent extracorporeal membrane oxygenation. A retrospective observational cohort study was performed at academic children's hospital for forty-three consecutive pediatric patients who required veno-arterial extracorporeal membrane (...) oxygenation (ECMO) support with refractory cardiogenic shock from January 2011 to October 2017. 30-day mortality in this cohort was 39.5% (17/43), and successful ECMO weaning rate was 69.8%. Blood lactate was elevated before ECMO implantation and the lactate peak concentration had significant differences between survivors and non-survivors, 8.4 ± 4.3 vs 13.9 ± 6.6 mmol/L. AUC to ROC curve analysis of lactate peak was 0.745 (p < 0.05), and the best cut-off value was 14.2 mmmol/L (sensitivity: 53

2019 Pediatric Cardiology

64. Recurrent Cardiogenic Shock Associated with Cannabis Use: Report of a Case and Review of the Literature. (Abstract)

Recurrent Cardiogenic Shock Associated with Cannabis Use: Report of a Case and Review of the Literature. The United States has recently undergone increases in the legalization and use of marijuana. There have been previous reports on the association of cannabis use and myocardial dysfunction, however, few on the association with acute stress cardiomyopathy and cardiogenic shock.This is a case of a 58-year-old female with a history of inhaled cannabis use, no history of diabetes, and no known (...) history of cardiac disease, that illustrates an association between cannabis use and the recurrent development of stress cardiomyopathy and cardiogenic shock. A review of medical records was performed from two hospitalizations and subsequent outpatient follow-up for similar presentations 6 years apart and review of literature regarding cannabis use and its association with cardiac dysfunction. In separate hospitalizations, the patient presented with clinical findings of cardiogenic shock, severe left

2019 Journal of Emergency Medicine

65. PCI Strategies in Patients with Acute Myocardial Infarction and Cardiogenic Shock. Full Text available with Trip Pro

PCI Strategies in Patients with Acute Myocardial Infarction and Cardiogenic Shock. In patients who have acute myocardial infarction with cardiogenic shock, early revascularization of the culprit artery by means of percutaneous coronary intervention (PCI) improves outcomes. However, the majority of patients with cardiogenic shock have multivessel disease, and whether PCI should be performed immediately for stenoses in nonculprit arteries is controversial.In this multicenter trial, we randomly (...) assigned 706 patients who had multivessel disease, acute myocardial infarction, and cardiogenic shock to one of two initial revascularization strategies: either PCI of the culprit lesion only, with the option of staged revascularization of nonculprit lesions, or immediate multivessel PCI. The primary end point was a composite of death or severe renal failure leading to renal-replacement therapy within 30 days after randomization. Safety end points included bleeding and stroke.At 30 days, the composite

2017 NEJM Controlled trial quality: predicted high

66. Risk Stratification for Patients in Cardiogenic Shock After Acute Myocardial Infarction Full Text available with Trip Pro

Risk Stratification for Patients in Cardiogenic Shock After Acute Myocardial Infarction Mortality in cardiogenic shock (CS) remains high. Early risk stratification is crucial to make adequate treatment decisions.This study sought to develop an easy-to-use, readily available risk prediction score for short-term mortality in patients with CS, derived from the IABP-SHOCK II (Intraaortic Balloon Pump in Cardiogenic Shock) trial.The score was developed using a stepwise multivariable regression (...) increase in mortality between the different score categories (0 to 2 vs. 3 to 4: p = 0.04; 0 to 2 vs. 5 to 9: p = 0.008).The IABP-SHOCK II risk score can be easily calculated in daily clinical practice and strongly correlated with mortality in patients with infarct-related CS. It may help stratify patient risk for short-term mortality and might, thus, facilitate clinical decision making. (Intraaortic Balloon Pump in Cardiogenic Shock II [IABP-SHOCK II]; NCT00491036).Copyright © 2017 American College

2017 EvidenceUpdates

67. Reconsidering Vasopressors for Cardiogenic Shock: Everything Should Be Made as Simple as Possible, but Not Simpler. Full Text available with Trip Pro

Reconsidering Vasopressors for Cardiogenic Shock: Everything Should Be Made as Simple as Possible, but Not Simpler. Scientific statements and publications have recommended the use of vasoconstrictors as the first-line pharmacologic choice for most cases of cardiogenic shock (CS), without the abundance of strong clinical evidence. One challenge of guidelines is that the way recommendations are stated can potentially lead to oversimplification of complex situations. Except for acute coronary

2019 Chest

68. Standardized Team-Based Care for Cardiogenic Shock. Full Text available with Trip Pro

Standardized Team-Based Care for Cardiogenic Shock. Cardiogenic shock (CS) is a multifactorial, hemodynamically complex syndrome associated with high mortality. Despite advances in reperfusion and mechanical circulatory support, management remains highly variable and outcomes poor.This study investigated whether a standardized team-based approach can improve outcomes in CS and whether a risk score can guide clinical decision making.A total of 204 consecutive patients with CS were identified. CS

2019 Journal of the American College of Cardiology

69. Acute Noncardiac Organ Failure in Acute Myocardial Infarction With Cardiogenic Shock. (Abstract)

Acute Noncardiac Organ Failure in Acute Myocardial Infarction With Cardiogenic Shock. There are limited data on acute noncardiac multiorgan failure in cardiogenic shock complicating acute myocardial infarction (AMI-CS).The authors sought to evaluate the 15-year national trends, resource utilization, and outcomes of single and multiple noncardiac organ failures in AMI-CS.This was a retrospective cohort study of AMI-CS using the National Inpatient Sample database from 2000 to 2014. Previously

2019 Journal of the American College of Cardiology

70. Percutaneous Coronary Intervention in Older Patients With ST-Segment Elevation Myocardial Infarction and Cardiogenic Shock. (Abstract)

Percutaneous Coronary Intervention in Older Patients With ST-Segment Elevation Myocardial Infarction and Cardiogenic Shock. Older adults ≥75 years of age carry an increased risk of mortality after ST-segment elevation myocardial infarction (STEMI) complicated by cardiogenic shock.The purpose of this study was to examine the use of percutaneous coronary intervention (PCI) in older adults with STEMI and shock and its influence on in-hospital mortality.We used a large publicly available all-payer (...) ). The diagnosis of STEMI and cardiogenic shock in older patients decreased significantly over time (proportion of older adults with STEMI and shock: 1999: 42% vs. 2013: 29%). Concomitantly, the rate of PCI utilization in older adults increased (1999: 27% vs. 2013: 56%, p < 0.001), with declining in-hospital mortality rates (1999: 64% vs. 2013: 46%; p < 0.001). Utilizing PS matching methods, PCI was associated with a lower risk of in-hospital mortality across quintiles of propensity score (Mantel-Haenszel odds

2019 Journal of the American College of Cardiology

71. In-hospital mortality of cardiogenic shock complicating ST-elevation myocardial infarction in Malaysia: a retrospective analysis of the Malaysian National Cardiovascular Database (NCVD) registry. Full Text available with Trip Pro

In-hospital mortality of cardiogenic shock complicating ST-elevation myocardial infarction in Malaysia: a retrospective analysis of the Malaysian National Cardiovascular Database (NCVD) registry. Cardiogenic shock (CS) complicating ST-elevation myocardial infarction (STEMI) carries an extremely high mortality. The clinical pattern of this life threatening complication has never been described in Malaysian setting. This study is to investigate the incidence, clinical characteristics and outcome

2019 BMJ open

72. Characteristics and Outcomes of Patients With Cardiogenic Shock Utilizing Hemodialysis for Acute Kidney Injury. (Abstract)

Characteristics and Outcomes of Patients With Cardiogenic Shock Utilizing Hemodialysis for Acute Kidney Injury. In the setting of cardiogenic shock (CS), impaired biventricular function can cause acute decrease in renal function via reduced renal perfusion and increased renal venous pressure. We sought to analyze the characteristics and outcomes of patients hospitalized with CS who utilized renal replacement therapy (hemodialysis) for acute kidney injury (AKI-HD). We utilized data from

2019 American Journal of Cardiology

73. Impella use in acute myocardial infarction complicated by cardiogenic shock and cardiac arrest: Analysis of 10 years registry data. (Abstract)

Impella use in acute myocardial infarction complicated by cardiogenic shock and cardiac arrest: Analysis of 10 years registry data. To assess characteristics and outcome of patients treated with Impella for acute myocardial infarction (AMI) complicated by severe cardiogenic shock (CS) or cardiac arrest (CA).From 2008 through 2017, 92 patients with AMI complicated by CS were treated with Impella. Survival varied according to clinical presentation. Patients in cardiogenic shock without CA had

2019 Resuscitation

74. 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

75. Protocol for an economic evaluation of the randomised controlled trial of culprit lesion only PCI versus immediate multivessel PCI in acute myocardial infarction complicated by cardiogenic shock: CULPRIT-SHOCK trial. Full Text available with Trip Pro

Protocol for an economic evaluation of the randomised controlled trial of culprit lesion only PCI versus immediate multivessel PCI in acute myocardial infarction complicated by cardiogenic shock: CULPRIT-SHOCK trial. Emergency percutaneous coronary intervention (PCI) of the culprit lesion for patients with acute myocardial infarctions is an accepted practice. A majority of patients present with multivessel disease with additional relevant stenoses apart from the culprit lesion (...) . In haemodynamically stable patients, there is increasing evidence from randomised trials to support the practice of immediate complete revascularisation. However, in the presence of cardiogenic shock, the optimal management strategy for additional non-culprit lesions is unknown. A multicentre randomised controlled trial, CULPRIT-SHOCK, is examining whether culprit vessel only PCI with potentially subsequent staged revascularisation is more effective than immediate multivessel PCI. This paper describes

2017 BMJ open Controlled trial quality: uncertain

76. Hemodynamic Analysis of Pediatric Septic Shock and Cardiogenic Shock Using Transpulmonary Thermodilution Full Text available with Trip Pro

Hemodynamic Analysis of Pediatric Septic Shock and Cardiogenic Shock Using Transpulmonary Thermodilution Septic shock and cardiogenic shock are the two most common types of shock in children admitted to pediatric intensive care units (PICUs). The aim of the study was to investigate which hemodynamic variables were associated with mortality in children with shock. We retrospectively analyzed 50 children with shock (37 septic shock cases and 13 cardiogenic shock cases) in the PICU and monitored (...) their hemodynamics using transpulmonary thermodilution from 2003 to 2016. Clinical factors were analyzed between the patients with septic and cardiogenic shock. In addition, hemodynamic parameters associated with mortality were analyzed. The 28-day mortality was significantly higher in the septic group than in the cardiogenic group (p = 0.016). Initially, the parameters of cardiac output and cardiac contractility were higher in the septic group (p < 0.05) while the parameters of preload and afterload were all

2017 BioMed research international

77. Inova Cardiogenic Shock Registry (INOVA SHOCK)

Inova Cardiogenic Shock Registry (INOVA SHOCK) Inova Cardiogenic Shock Registry (INOVA SHOCK) - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Inova Cardiogenic Shock Registry (INOVA SHOCK) (INOVASHOCK (...) by (Responsible Party): Alexander G. Truesdell, Inova Health Care Services Study Details Study Description Go to Brief Summary: To collect retrospective clinical outcomes related to acute decompensated heart failure cardiogenic shock, acute myocardial infarction cardiogenic shock and compare current versus historical survival rates. To collect Inova Heart and Vascular Institute (IHVI) site specific outcomes before and after initiation of the Cardiogenic Shock team on January 1, 2017. To collect outcomes

2017 Clinical Trials

78. Another Nail in the Coffin for Intra-Aortic Balloon Counterpulsion in Acute Myocardial Infarction With Cardiogenic Shock. Full Text available with Trip Pro

Another Nail in the Coffin for Intra-Aortic Balloon Counterpulsion in Acute Myocardial Infarction With Cardiogenic Shock. 30586784 2019 02 05 1524-4539 139 3 2019 Jan 15 Circulation Circulation Another Nail in the Coffin for Intra-Aortic Balloon Counterpulsion in Acute Myocardial Infarction With Cardiogenic Shock. 404-406 10.1161/CIRCULATIONAHA.118.038279 Katz Stuart D SD Cardiovascular Clinical Research Center, Division of Cardiology, Department of Medicine, New York University School (...) UL1 TR001445 TR NCATS NIH HHS United States Editorial United States Circulation 0147763 0009-7322 Circulation. 2019 Jan 15;139(3):e9 30640539 Editorials myocardial infarction shock, cardiogenic 2020 01 15 2018 12 28 6 0 2018 12 28 6 0 2018 12 28 6 0 ppublish 30586784 10.1161/CIRCULATIONAHA.118.038279 PMC6331234 NIHMS1510053

2018 Circulation

79. Outcomes Associated With Cardiogenic Shock in Takotsubo Syndrome: Results From the International Takotsubo Registry. Full Text available with Trip Pro

Outcomes Associated With Cardiogenic Shock in Takotsubo Syndrome: Results From the International Takotsubo Registry. 30586690 2019 01 14 1524-4539 139 3 2019 Jan 15 Circulation Circulation Outcomes Associated With Cardiogenic Shock in Takotsubo Syndrome. 413-415 10.1161/CIRCULATIONAHA.118.036164 Di Vece Davide D Department of Cardiology, University Heart Center, University Hospital Zurich, Switzerland (D.D.V., V.L.C., K.K., S.G., K.A.S., J.M., S.J., K.J.D., B.B., M.S., A.C., F.R., J.R.G., C.T (...) , University Hospital Zurich, Switzerland (D.D.V., V.L.C., K.K., S.G., K.A.S., J.M., S.J., K.J.D., B.B., M.S., A.C., F.R., J.R.G., C.T.). eng Letter United States Circulation 0147763 0009-7322 broken heart syndrome cardiac mechanical support cardiogenic shock outcome takotsubo syndrome 2018 12 28 6 0 2018 12 28 6 0 2018 12 28 6 0 ppublish 30586690 10.1161/CIRCULATIONAHA.118.036164

2018 Circulation

80. Extracorporeal Membrane Oxygenation Use in Cardiogenic Shock: Impact of Age on In-Hospital Mortality, Length of Stay, and Costs. Full Text available with Trip Pro

Extracorporeal Membrane Oxygenation Use in Cardiogenic Shock: Impact of Age on In-Hospital Mortality, Length of Stay, and Costs. Increasing age is a well-recognized risk factor for in-hospital mortality in patients receiving extracorporeal membrane oxygenation for cardiogenic shock, but the shape of this relationship is unknown. In addition, the impact of age on hospital length of stay, patterns of patient disposition, and costs has been incompletely characterized.Retrospective analysis (...) of the National Inpatient Sample.U.S. nonfederal hospitals, years 2004-2016.Adults with cardiogenic shock treated with extracorporeal membrane oxygenation (3,094; weighted national estimate: 15,415).None.The mean age of extracorporeal membrane oxygenation recipients was 54.8 ± 15.4 years (range, 18-90 yr). Crude in-hospital mortality was 57.7%. Median time-to-death was 8 days (interquartile range, 3-17 d). A linear relationship between age and in-hospital mortality was observed with a 14% increase

2018 Critical Care Medicine

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