[Cardiogenic shock in acute coronary syndrome--therapeutic approach].
OBJECTIVE
Cardiogenic shock is the most serious complication of acute coronary syndromes and cause of death in 4.2-7.2% of patients with acute ST-elevation myocardial infarction (STEMI), in 2.1% of patients with acute non-ST-elevation myocardial infarction and in 2.9% of patients with unstable angina pectoris. The cardiogenic shock mortality rate of 80% in patients treated conservatively has been decreased with the introduction of primary percutaneous coronary intervention (PCI) in the treatment of STEMI. The incidence and mortality rate were assessed in patients with cardiogenic shock treated with primary PCI at Department of Cardiovascular Diseases, Sestre Milosrdnice University Hospital.


METHODS
Since 2000, the emergency interventional cardiologic service has been available for 24 h at the Department. During this period, 701 patients were hospitalized with the diagnosis of STEMI, 312 of them meeting the recommended criteria, were treated with primary PCI.


RESULTS
According to study results, the incidence of cardiogenic shock in STEMI patients was 8.3%. Treatment with primary PCI decreased cardiogenic shock mortality rate to 35%.


CONCLUSIONS
Primary PCI is definitely therapy of choice in the treatment of this serious complication of acute STEMI.
Heitzler
Vjeran Nikolić
VN
Koronarna jedinica, Zavod za kardiovaskularne bolesti Interne klinike, Klinicka bolnica Sestre milosrdnice, Vinogradska 29 10000 Zagreb, Hrvatska.
Babić
Zdravko
Z
Manola
Sime
S
Bulj
Nikola
N
Mihatov
Sime
S
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D012770:Shock, Cardiogenic / Q000209:etiology* / Q000628:therapy*