title: [Cardiogenic shock in the course of myocardial infarction--the results of treatment during hospitalization and in long-term follow-up].
abstract: Cardiogenic shock develops in 5-15% of patients hospitalised with acute myocardial infarction. It is responsible for more than a half of all hospital deaths with survival rate of about 20%. Conventional medical therapy with use of adrenergic, vasoactive, inotropic and thrombolytic agents has failed to improve survival. Treatment strategy combine hemodynamic stabilisation with restoration of coronary blood flow. The aim of the study was evaluation of mechanical restoration of coronary blood flow in infarction related artery and to assess its influence on mortality in patients with myocardial infarction complicated by cardiogenic shock. We retrospectively analysed 58 subjects: 26 patients treated by primary angioplasty, 25 patients with PTCA angioplasty after streptokinase treatment and 7 ones treated conservatively. TIMI 3 flow in angioplasty treated patients was achieved in 70.6% with in hospital mortality rate 14%, however, when reperfusion was unsuccessful the mortality was high (80%). 12 months follow-up mortality rate was 41.8%.
  
  
  CONCLUSIONS
  Successful reperfusion with coronary angioplasty of the infarct-related artery can significantly reduce mortality rate in patients with cardiogenic shock. Patients who survived in-hospital period have favourable one-year prognosis.
authors.affiliation: III Katedry i Klinicznego Oddziału Kardiologii, Slaskiego Centrum Chorób Serca, Zabrzu. scchs@slam.katowice.pl
authors.forename: Mariusz
authors.initials: M
authors.lastname: Gasior
authors.forename: Jarosław
authors.initials: J
authors.lastname: Wasilewski
authors.forename: Marek
authors.initials: M
authors.lastname: Gierlotka
authors.forename: Tadeusz
authors.initials: T
authors.lastname: Zebik
authors.forename: Janusz
authors.initials: J
authors.lastname: Szkodziński
authors.forename: Marek
authors.initials: M
authors.lastname: Kondys
authors.forename: Andrzej
authors.initials: A
authors.lastname: Lekston
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Wilczek
authors.forename: Rafał
authors.initials: R
authors.lastname: Wojnar
authors.forename: Andrzej
authors.initials: A
authors.lastname: Wnek
authors.forename: Romuald
authors.initials: R
authors.lastname: Wojnicz
authors.forename: Bozena
authors.initials: B
authors.lastname: Szyguła
authors.forename: Elzbieta
authors.initials: E
authors.lastname: Adamowicz
authors.forename: Marian
authors.initials: M
authors.lastname: Zembala
authors.forename: Lech
authors.initials: L
authors.lastname: Poloński
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000628:therapy; D012189:Retrospective Studies; D012770:Shock, Cardiogenic / Q000209:etiology / Q000401:mortality* / Q000628:therapy*; D013300:Streptokinase / Q000627:therapeutic use; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D013300:Streptokinase