Klinikum Ludwigshafen, Germany.
Institut für Herzinfarktforschung, Germany.
Eur Heart J Acute Cardiovasc Care. 2020 Mar;9(2):183-197. doi: 10.1177/2048872619894254. Epub 2020 Mar 2.
Most of the guideline-recommended treatment strategies for patients with acute coronary syndromes have been tested in large randomised clinical trials. Still, a major challenge is represented by patients with acute myocardial infarction admitted with impending or established cardiogenic shock. Despite early revascularization the mortality of cardiogenic shock remains high and roughly half of patients do not survive until hospital discharge or 30-day follow-up. However, there is only limited evidence-based scientific knowledge in the cardiogenic shock setting. Therefore, recommendations and actual treatments are often based on retrospective or prospective registry data and extrapolations from randomised clinical trials in acute myocardial infarction patients without cardiogenic shock. This position statement will summarise the current consensus of the diagnosis and treatment of patients with acute myocardial infarction complicated by cardiogenic shock based on current evidence and will provide advice for clinical practice.
大多数急性冠状动脉综合征患者的指南推荐治疗策略都已经在大型随机临床试验中得到了检验。然而,一个主要的挑战是患有急性心肌梗死并伴有即将发生或已经发生的心源性休克的患者。尽管进行了早期血运重建,心源性休克患者的死亡率仍然很高,大约有一半的患者无法存活到出院或 30 天随访。然而,在心源性休克的情况下,科学知识的证据有限。因此,建议和实际治疗通常基于回顾性或前瞻性登记数据,以及从没有心源性休克的急性心肌梗死患者的随机临床试验中推断而来。本立场声明将根据现有证据总结目前对急性心肌梗死合并心源性休克患者的诊断和治疗的共识,并为临床实践提供建议。