Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia.
Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia.
J Am Coll Cardiol. 2018 Oct 16;72(16):1972-1980. doi: 10.1016/j.jacc.2018.07.074.
Despite advances over the past decade, the incidence of cardiogenic shock secondary to acute myocardial infarction has increased, with an unchanged mortality near 50%. Recent trials have not clarified the best strategies in treatment. While dedicated cardiac shock centers are being established, there are no standardized agreements on the utilization of mechanical circulatory support and the timeliness of percutaneous coronary intervention strategies. In some centers and prospective registries, outcomes after placement of advanced mechanical circulatory support prior to reperfusion therapy with percutaneous coronary intervention have been encouraging with improved survival. Here, we suggest systems of care with a treatment pathway for patients with acute myocardial infarction complicated by cardiogenic shock.
尽管在过去十年中取得了进展，但急性心肌梗死后心源性休克的发病率仍在增加，死亡率接近 50%，且保持不变。最近的试验并未阐明治疗的最佳策略。虽然正在建立专门的心源性休克中心，但在机械循环支持的利用和经皮冠状动脉介入策略的及时性方面尚无标准化协议。在一些中心和前瞻性登记处，在经皮冠状动脉介入再灌注治疗之前放置先进的机械循环支持后的结果令人鼓舞，生存率有所提高。在这里，我们为患有急性心肌梗死合并心源性休克的患者提出了一种治疗途径的护理系统。
