J Cardiovasc Interv.  2025 Jul;4(3):212-222. 10.54912/jci.2025.0004.

Strategies of Revascularization and Mechanical Circulatory Support for Acute Myocardial Infarction Complicated by Cardiogenic Shock: A Systematic Review With Updated Evidence

• Lim Y
• Kim MC
• Oh S
• Ahn JH
• Lee SH
• Hyun DY
• Cho KH
• Sim DS
• Hong YJ
• Kim J
• Ahn Y

• KMID: 2570252
• DOI: http://doi.org/10.54912/jci.2025.0004

Abstract

Cardiogenic shock (CS) is a life-threatening condition associated with cardiac disorders, especially acute myocardial infarction (AMI). Approximately 5–10% of patients with AMI develop CS, and these patients exhibit considerably higher in-hospital mortality rates than those with AMI alone. Consequently, there is an urgent need to improve the management of AMI complicated by CS (AMI-CS). Over the past 30 years, advances in management have emerged from milestone studies. Key improvements include emergency revascularization, infarct-related artery-only percutaneous coronary intervention for multivessel disease, and the appropriate use of mechanical circulatory support, among other strategies. Additionally, overall enhancements in patient care have contributed to improved outcomes. In this article, we explore the pathophysiology of AMI-CS and review current recommendations, which are supported by evidence from notable randomized controlled trials.

Keyword

Myocardial infarction; Acute coronary syndrome; Cardiogenic shock; Percutaneous coronary intervention; Extracorporeal membrane oxygenation; Heart-assist devices