Saito Yuichi, Tateishi Kazuya, Kobayashi Yoshio
Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine Chiba Japan.
Circ Rep. 2024 Nov 29;7(1):6-14. doi: 10.1253/circrep.CR-24-0141. eCollection 2025 Jan 10.
Owing to recent advances in early reperfusion and pharmacological therapies, the prognosis of patients with acute myocardial infarction (AMI) has considerably improved over the past decades. However, the mortality rate remains high at ~40-50% after AMI when complicated by cardiogenic shock. Although immediate coronary revascularization of the infarct-related artery has been the only evidence-based treatment, temporary mechanical circulatory support with a microaxial flow pump (Impella) has become another therapeutic option supported by randomized trial data in highly selected patients. Here we summarize the latest evidence concerning clinical challenges in patients with AMI and cardiogenic shock.
由于早期再灌注和药物治疗的最新进展，在过去几十年中，急性心肌梗死（AMI）患者的预后有了显著改善。然而，当AMI并发心源性休克时，死亡率仍高达约40-50%。尽管梗死相关动脉的即时冠状动脉血运重建一直是唯一基于证据的治疗方法，但在经过高度筛选的患者中，使用微轴流泵（Impella）进行临时机械循环支持已成为另一种有随机试验数据支持的治疗选择。在此，我们总结了有关AMI并发心源性休克患者临床挑战的最新证据。
