Regular paperAbciximab therapy improves survival in patients with acute myocardial infarction complicated by early cardiogenic shock undergoing coronary artery stent implantation☆
Section snippets
Study patient cohort
The study included consecutive patients with AMI complicated by CS who underwent IRA stenting between January 1999 and July 2001. CS due to predominant ventricular failure was defined as systolic blood pressure <90 mm Hg (without inotropic or intra-aortic balloon support) associated with signs of end-organ hypoperfusion, such as cold or diaphoretic extremities, altered mental status, or anuria. The diagnosis of CS due to predominant ventricular failure was confirmed by cardiac catheterization
Study cohort, and procedural and clinical outcomes
Between January 1999 and July 2001, 739 patients with AMI underwent percutaneous mechanical intervention. Of these, 84 patients (11%) had CS due to predominant ventricular failure. Three patients had 3 primary failures (4%), whereas 4 patients (5%), all with a IRA diameter <2.5 mm, had successful coronary angioplasty without stent implantation. The remaining 77 patients with successful IRA stenting were considered for analysis. Abciximab therapy was administered to 44 patients (57%), whereas
Abciximab and IRA stenting for AMI complicated by CS
Previous randomized studies comparing abciximab therapy as an adjunct to IRA stenting with IRA stenting alone in patients without CS have produced conflicting results. The Abciximab before Direct angioplasty and stenting in Myocardial Infarction Regarding Acute and Long term follow-up (ADMIRAL) trial and the Intracoronary Stenting and Antithrombotic Regimen (ISAR-2) trial have demonstrated a benefit of abciximab therapy as an adjunct to IRA stent implantation in terms of reduction of the
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Cited by (72)
Glycoprotein IIb/IIIa inhibitor use in cardiogenic shock complicating myocardial infarction: The Portuguese Registry of Acute Coronary Syndromes
2023, Revista Portuguesa de CardiologiaPostmyocardial infarction cardiogenic shock
2018, Cardiac Intensive CareCangrelor or Abciximab as First Choice in Cardiogenic Shock
2017, JACC: Cardiovascular InterventionsImpact of access site choice on outcomes of patients with cardiogenic shock undergoing percutaneous coronary intervention: A systematic review and meta-analysis
2015, American Heart JournalCitation Excerpt :It is possible that bleeding-related hemodynamic instability and other adverse influences such as blood transfusion–related oxidative stress may compound the effects of an already hostile milieu that exists in this patient subset, further compromising outcomes. Because of a lower probability of access site bleeding associated with TRA, it is likely that these patients receive more aggressive antithrombotic therapy, especially potent parenteral antiplatelet therapy using GP2b/3a inhibitors, which have been shown to improve outcomes in patients with CS.26 In the RADIAL-PUMP UP registry, patients with IABP undergoing PCI via TFA experienced a higher risk of access site bleeding in comparison with patients undergoing PCI via TRA.
Cardiogenic shock
2010, Cardiac Intensive Care: Expert ConsultCardiogenic Shock
2010, Cardiac Intensive Care
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This study was supported by the A.R. Cardiology ONLUS Foundation, Florence, Italy.