Interventional treatment of acute myocardial infarction-related cardiogenic shock

Abstract

Purpose of reviewAcute revascularization is with some evidence the only intervention proven to improve the prognosis in myocardial infarction-related cardiogenic shock but several interventions are continuously being investigated in order to increase survival among these patients. In this review, several aspects related to the interventional treatment of cardiogenic shock are discussed chronologically from symptom debut to leaving the cardiac catheterization laboratory.Recent findingsIn the randomized CULPRIT-SHOCK trial, a culprit-only revascularization strategy was reported superior to immediate complete revascularization among patients with multivessel disease. Recent large-scale observational data underline the marked prognostic importance of time from medical contact to revascularization in acute myocardial infarction-related cardiogenic shock. Moreover, studies suggest a potential beneficial effect of a transradial vascular access as well as early initialization of mechanical circulatory support in carefully selected patients. This, however, needs further validation.SummaryAcute revascularization remains a crucial part of the initial management of acute myocardial infarction-related cardiogenic shock. Among cardiogenic shock patients presenting with multivessel disease, a culprit-only approach should be the routine strategy. Time to revascularization plays a crucial role in the setting of cardiogenic shock, why prehospital optimization and triaging may be the most important factors in order to improve prognosis in AMI-related cardiogenic shock.

Cardiac Magnetic Resonance Assessment of the Protective Effect of Remote Ischemic Postconditioning on Coronary Microcirculation after Reperfusion Therapy for Acute ST-Segment Elevation Myocardial Infarction

“…The pathological mechanism is the blockage of the microvascular lumen by platelets, leukocyte debris and microthrombi, edema of the endothelium, or compression by edema of the myocardial tissue, as well as the pathological inflammatory response, vasospasm due to thrombus, and vasoconstrictor secreted by the endothelium [ 13 ]. Persistent myocardial ischemia and massive necrosis due to no recurrent flow are important determinants of death and other adverse events after infarction [ 14 ]. However, in recent years, it has been found that prolonged microcirculatory impairment with severe tissue ischemia and hypoxia can lead to destruction of capillary walls and spillage of red blood cells from the vessels into the tissue interstitium, a more severe form of reperfusion injury [ 15 ].…”

“…Persistent myocardial ischemia and massive necrosis due to no recurrent flow are important determinants of death and other adverse events after infarction [14]. However, in recent years, it has been found that prolonged microcirculatory impairment with severe tissue ischemia and hypoxia can lead to destruction of capillary walls and spillage of red blood cells from the vessels into the tissue interstitium, a more severe form of reperfusion injury [15].…”

Analysis of susceptibility genes and myocardial infarction risk correlation of ischemic cardiomyopathy based on bioinformatics

“…In this study, through bioinformatics, differential expression of mRNA of ICM functional annotation (GO and KEGG) pathway analysis, it was shown that there was significant enrichment in fibrosis and endoplasmic reticulum stress pathways, and that these pathways prompt the pathogenesis of ICM (33). In addition, we also constructed differentially expressed lncRNA-related Hub gene networks in ICM.…”

Clinical Application of Cardiac Rehabilitation Program Based on Self-efficacy Theory in Patients with Acute Myocardial Infarction Undergoing Percutaneous Transluminal Coronary Intervention

“…PCI is employed to recanalize stenosed or occluded coronary arteries, facilitating reperfusion of the ischemic myocardium and thereby improving cardiac function. It has become a primary clinical treatment for AMI [16]. However, post-PCI, a majority of patients experience psychological stress, leading to varying degrees of negative emotions.…”