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Japanese

Coronary Angiographic Findings and Effects of Reperfusion Therapies in Acute Myocardial Infarction with Cardiogenic Shock Hiroshi Nakashima 1 , Yukiharu Honda 1 , Ryo Imanishi 1 , Yuji Matsumoto 1 , Tomoyuki Katayama 1 1Department of Cardiology, Nagasaki Citizens Hospital Keyword: 急性心筋梗塞 , 心原性ショック , 再灌流療法 , acute myocardial infarction , cardiogenic shock , reperfusion therapy pp.909-914
Published Date 1995/9/15
DOI https://doi.org/10.11477/mf.1404901119
  • Abstract
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Cardiogenic shock is the most serious complication of acute myocardial infarction (AMI) and has a very high mortality rate (65-97%). The present study was designed to evaluate clinical characteristics. coronary angiographic findings and the effects of reperfusion therapies in 17 shock patients as compared to those in 60 patients without shock. The in-hospital mortality rate was significantly higher for patients with shock than for patients without shock (24% vs 5%, p<0.05). In 35% of the shock group, “extension” was observed at least 24 hours after admission and this developed into a shock state. Four of 8 patients with inferior infarction complicated by shock showed right ventricular infarc-tion. Coronary angiographic findings revealed that extensive three-vessel disease was a more common finding in patients with shock than in patients without shock (53% vs 9%, p<0.001). Other angiographic findings in shock cases included severe calcification of the coronary arteries and poor development of collat. erals to the infarct-related artery (IRA). Success rate after reperfusion therapies was significantly lower in patients with shock than in patients without shock (55% vs 86%, p<0.05) Concerning these shock patients, in-hospital mortality rate seemed to depend closely upon IRA patency.

The above findings suggest that the establishment of patency of the IRA is the most important therepeutic strategy for acute myocardial infarction complicated by cardiogenic shock. The prevention of extension might be another important strategy to reduce the incidence of cardiogenic shock.


Copyright © 1995, Igaku-Shoin Ltd. All rights reserved.

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