Coronary Intervention of Cardiogenic Shock in Acute Myocardial Infarction

Choi, Jae Woong; Song, Chang Sup; Imm, Chin Woo; Ahn, Tae Hoon; Choi, In Seog; Shin, Ik Kyun; Park, Young Hoon

Abstract

BACKGROUND
Despite improvement of mortality in acute myocardial infarcrtion, high mortality rate associated with cardiogenic shock remains essentially unchanged. We have reviewed our result of coronary intervention in 15 patients and found relative survival advantage.
METHODS
Between Sep. 1992 and Aug. 1995, 15 consecutive patients(M. 10, F. 5) with cardiogenic shock in acute myocardial infarction were treated with coronary intervention using ballon PTCA. IABP was inserted in all patients prior to PTCA.
RESULTS
1) Most commonly found infarct related artery was left anterior descending artery(11) followed by right coronary artery(3) and left main coronary artery(1). 2) Successful reperfusion rate was 86.7%(13/15), and in-hospital mortality rate was 26.7%(4/15). 3) In-hospital mortality was higher in elderly patients compared with less than 70yaer old patients(0%(0/11)vs. 75.0%(3/4)(P < 0.05). 4) Mortality rate was lower in single vessel disease than multivessel disease(11.1%(1/9) vs. 50%(3/6) p<0.05).
CONCLUSION
Although this study is uncontrolled, the date suggest that urgent coronary intervention for improving coronary perfusion may reduce mortality of acute myocardial infarction complicated by cardiogenic shock, particularly with single vessel disease and young age group.