• Milena Soriano Marcolino, Cihan Simsek, Sanneke P M de Boer, Ron T van Domburg, Robert-Jan van Geuns, Peter de Jaegere, K Martijn Akkerhuis, Joost Daemen, Patrick W Serruys, and Eric Boersma.
• Department of Cardiology, Erasmus MC, 's Gravendijkwal 230, Rotterdam, The Netherlands.
• Cardiology. 2012 Jan 1;121(1):47-55.

ObjectivesTo determine the risk of short- and long-term mortality and major adverse cardiac events (MACE) in acute myocardial infarction (AMI) patients complicated by cardiogenic shock (CS) in the contemporary practice of primary percutaneous coronary intervention with stenting.MethodsOf the 1,755 consecutive AMI patients undergoing percutaneous coronary intervention with stenting enrolled, 103 had CS at admission. Primary endpoints were early mortality (within 30 days after the index event) and late mortality (from day 31 up to 4 years). Secondary endpoints included MACE [all-cause death, myocardial infarction or target vessel revascularization (TVR)], myocardial infarction, TVR and stent thrombosis.ResultsThirty-day mortality was higher among CS patients, and CS was a strong independent predictor of a higher risk of early death (adjusted HR 3.64, 95% CI 2.44-5.44). The late mortality rate was significantly higher in CS patients, and CS was also a predictor of higher risk of death at a 4-year follow-up (adjusted HR 1.95, 95% CI 1.11-3.45). Recurrent AMI, TVR and stent thrombosis rates were similar among patients with and without CS.ConclusionCS complicating AMI is still a severe clinical event, mainly with regard to a significant higher risk of early mortality, but also associated with a worse prognosis in 30-day survivors.Copyright © 2012 S. Karger AG, Basel.

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