Patients with extensive acute myocardial infarctions may develop cardiogenic shock, which has been associated with marked contractile dysfunction due to ischemia. These patients often present with multivessel coronary artery disease.
355 STEMI patients from the DanGer Shock study were analyzed. The inclusion criterion was lactate level ≥2.5 mmol/L and left ventricular ejection fraction ≤45%. Patients in coma were excluded.
This post-hoc analysis evaluated all-cause mortality according to revascularization strategy: culprit-only PCI (VC-PCI, n=118) vs. immediate multivessel PCI (MV-PCI, n=103).
All-cause mortality resulted lower among MV-PCI patients vs. VC-PCI patients (OR 0.65; 95% CI 0.38–1.11). After adjusting for confounding factors, the association was even more significant (OR 0.40; 95% CI 0.19–0.83).
The authors concluded that, in this subanalysis, immediate complete revascularization (MV-PCI) was associated with reduced 180-day mortality in patients with cardiogenic shock secondary to STEMI. These findings contrast with those of previous landmark trials, such as CULPRIT-SHOCK.
Presented by R. P. Beske during the Major Late Breaking Trials session, EuroPCR 2025, May 21, Paris, France.
Subscribe to our weekly newsletter
Get the latest scientific articles on interventional cardiology
