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Acute Myocardial Infarction and Cardiogenic Shock Interventional Approach to Management in the Cardiac Catheterization Laboratories
Despite advances in early reperfusion and a technologic renaissance in the space of Mechanical Circulatory Support (MCS), Cardiogenic Shock (CS) remains the leading cause of in-hospital mortality following Acute Myocardial Infarction (AMI). Given the challenges inherent to conducting adequately powe...
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Published in: | Current cardiology reviews 2022-03, Vol.18 (2), p.e251121198293-e251121198293 |
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description | Despite advances in early reperfusion and a technologic renaissance in the space of Mechanical Circulatory Support (MCS), Cardiogenic Shock (CS) remains the leading cause of in-hospital mortality following Acute Myocardial Infarction (AMI). Given the challenges inherent to conducting adequately powered randomized controlled trials in this time-sensitive, hemodynamically complex, and highly lethal syndrome, treatment recommendations have been derived from AMI patients without shock. In this review, we aimed to (1) examine the pathophysiology and the new classification system for CS; (2) provide a comprehensive, evidence-based review for best practices for interventional management of AMI-CS in the cardiac catheterization laboratory; and (3) highlight the concept of how frailty and geriatric syndromes can be integrated into the decision process and where medical futility lies in the spectrum of AMI-CS care. Management strategies in the cardiac catheterization laboratory for CS include optimal vascular access, periprocedural antithrombotic therapy, culprit lesion versus multi-vessel revascularization, selective utilization of hemodynamic MCS tailored to individual shock hemometabolic profiles, and management of cardiac arrest. Efforts to advance clinical evidence for patients with CS should be concentrated on (1) the coordination of multi-center registries; (2) development of pragmatic clinical trials designed to evaluate innovative therapies; (3) establishment of multidisciplinary care models that will inform quality care and improve clinical outcomes. |
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Given the challenges inherent to conducting adequately powered randomized controlled trials in this time-sensitive, hemodynamically complex, and highly lethal syndrome, treatment recommendations have been derived from AMI patients without shock. In this review, we aimed to (1) examine the pathophysiology and the new classification system for CS; (2) provide a comprehensive, evidence-based review for best practices for interventional management of AMI-CS in the cardiac catheterization laboratory; and (3) highlight the concept of how frailty and geriatric syndromes can be integrated into the decision process and where medical futility lies in the spectrum of AMI-CS care. Management strategies in the cardiac catheterization laboratory for CS include optimal vascular access, periprocedural antithrombotic therapy, culprit lesion versus multi-vessel revascularization, selective utilization of hemodynamic MCS tailored to individual shock hemometabolic profiles, and management of cardiac arrest. Efforts to advance clinical evidence for patients with CS should be concentrated on (1) the coordination of multi-center registries; (2) development of pragmatic clinical trials designed to evaluate innovative therapies; (3) establishment of multidisciplinary care models that will inform quality care and improve clinical outcomes.</description><identifier>ISSN: 1573-403X</identifier><identifier>EISSN: 1875-6557</identifier><identifier>DOI: 10.2174/1573403X17666211125090929</identifier><identifier>PMID: 34823461</identifier><language>eng</language><publisher>United Arab Emirates: Benham Science Publishers</publisher><subject>Aged ; Best practice ; Cardiac catheterization ; Cardiac Catheterization - adverse effects ; Catheterization ; Clinical trials ; Heart ; Heart attacks ; Hemodynamics ; Humans ; Intubation ; Laboratories ; Myocardial infarction ; Myocardial Infarction - complications ; Myocardial Infarction - therapy ; Patients ; Reperfusion ; Shock ; Shock, Cardiogenic - diagnosis ; Shock, Cardiogenic - etiology ; Shock, Cardiogenic - therapy ; Treatment Outcome</subject><ispartof>Current cardiology reviews, 2022-03, Vol.18 (2), p.e251121198293-e251121198293</ispartof><rights>Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.</rights><rights>Copyright Bentham Science Mar 2022</rights><rights>2022 Bentham Science Publishers 2022</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c451t-c5742acf9fca56814575ea776a04af03ecdb07a54515c3d00f2c23513a4ce47d3</citedby><cites>FETCH-LOGICAL-c451t-c5742acf9fca56814575ea776a04af03ecdb07a54515c3d00f2c23513a4ce47d3</cites><orcidid>0000-0002-8037-7021 ; 0000-0002-8774-6416 ; 0000-0002-3016-1150</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9413732/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9413732/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,733,786,790,891,27957,27958,53827,53829</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34823461$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tehrani, Behnam N</creatorcontrib><creatorcontrib>Damluji, Abdulla A</creatorcontrib><creatorcontrib>Batchelor, Wayne B</creatorcontrib><title>Acute Myocardial Infarction and Cardiogenic Shock Interventional Approach to Management in the Cardiac Catheterization Laboratories</title><title>Current cardiology reviews</title><addtitle>Curr Cardiol Rev</addtitle><description>Despite advances in early reperfusion and a technologic renaissance in the space of Mechanical Circulatory Support (MCS), Cardiogenic Shock (CS) remains the leading cause of in-hospital mortality following Acute Myocardial Infarction (AMI). Given the challenges inherent to conducting adequately powered randomized controlled trials in this time-sensitive, hemodynamically complex, and highly lethal syndrome, treatment recommendations have been derived from AMI patients without shock. In this review, we aimed to (1) examine the pathophysiology and the new classification system for CS; (2) provide a comprehensive, evidence-based review for best practices for interventional management of AMI-CS in the cardiac catheterization laboratory; and (3) highlight the concept of how frailty and geriatric syndromes can be integrated into the decision process and where medical futility lies in the spectrum of AMI-CS care. Management strategies in the cardiac catheterization laboratory for CS include optimal vascular access, periprocedural antithrombotic therapy, culprit lesion versus multi-vessel revascularization, selective utilization of hemodynamic MCS tailored to individual shock hemometabolic profiles, and management of cardiac arrest. Efforts to advance clinical evidence for patients with CS should be concentrated on (1) the coordination of multi-center registries; (2) development of pragmatic clinical trials designed to evaluate innovative therapies; (3) establishment of multidisciplinary care models that will inform quality care and improve clinical outcomes.</description><subject>Aged</subject><subject>Best practice</subject><subject>Cardiac catheterization</subject><subject>Cardiac Catheterization - adverse effects</subject><subject>Catheterization</subject><subject>Clinical trials</subject><subject>Heart</subject><subject>Heart attacks</subject><subject>Hemodynamics</subject><subject>Humans</subject><subject>Intubation</subject><subject>Laboratories</subject><subject>Myocardial infarction</subject><subject>Myocardial Infarction - complications</subject><subject>Myocardial Infarction - therapy</subject><subject>Patients</subject><subject>Reperfusion</subject><subject>Shock</subject><subject>Shock, Cardiogenic - diagnosis</subject><subject>Shock, Cardiogenic - etiology</subject><subject>Shock, Cardiogenic - therapy</subject><subject>Treatment Outcome</subject><issn>1573-403X</issn><issn>1875-6557</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNp1kU2LFDEQhoMo7jr6FyTixUtrvjN9EYbBj4VZPKjgLdRUp2ey9iRj0r2wXv3jpp11UcFTJVXP-1LJS8gzzl4KbtUrrq1UTH7h1hgjOOdCs5a1or1HzvnS6sZobe_Xc-WaGTwjj0q5YkwL0_KH5EyqpZDK8HPyY4XT6OnlTULIXYCBXsQeMo4hRQqxo-u5nXY-BqQf9wm_VmD0-drHGan86njMCXBPx0QvIcLOH-qMhkjHvT_JAWutt6oL3-GX9Qa2KcOYcvDlMXnQw1D8k9u6IJ_fvvm0ft9sPry7WK82DSrNxwa1VQKwb3sEbZZcaas9WGuAKeiZ9NhtmQVdYY2yY6wXKKTmEhR6ZTu5IK9Pvsdpe_Ad1jUzDO6YwwHyjUsQ3N-TGPZul65dq7i0UlSDF7cGOX2bfBndIRT0wwDRp6k4YZhi3GjOKvr8H_QqTbn-10wpyZbMVssFaU8U5lRK9v3dMpy5OWr336ir9umfr7lT_s5W_gSVjadQ</recordid><startdate>20220301</startdate><enddate>20220301</enddate><creator>Tehrani, Behnam N</creator><creator>Damluji, Abdulla A</creator><creator>Batchelor, Wayne B</creator><general>Benham Science Publishers</general><general>Bentham Science Publishers</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>P64</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-8037-7021</orcidid><orcidid>https://orcid.org/0000-0002-8774-6416</orcidid><orcidid>https://orcid.org/0000-0002-3016-1150</orcidid></search><sort><creationdate>20220301</creationdate><title>Acute Myocardial Infarction and Cardiogenic Shock Interventional Approach to Management in the Cardiac Catheterization Laboratories</title><author>Tehrani, Behnam N ; Damluji, Abdulla A ; Batchelor, Wayne B</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c451t-c5742acf9fca56814575ea776a04af03ecdb07a54515c3d00f2c23513a4ce47d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Aged</topic><topic>Best practice</topic><topic>Cardiac catheterization</topic><topic>Cardiac Catheterization - adverse effects</topic><topic>Catheterization</topic><topic>Clinical trials</topic><topic>Heart</topic><topic>Heart attacks</topic><topic>Hemodynamics</topic><topic>Humans</topic><topic>Intubation</topic><topic>Laboratories</topic><topic>Myocardial infarction</topic><topic>Myocardial Infarction - complications</topic><topic>Myocardial Infarction - therapy</topic><topic>Patients</topic><topic>Reperfusion</topic><topic>Shock</topic><topic>Shock, Cardiogenic - diagnosis</topic><topic>Shock, Cardiogenic - etiology</topic><topic>Shock, Cardiogenic - therapy</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tehrani, Behnam N</creatorcontrib><creatorcontrib>Damluji, Abdulla A</creatorcontrib><creatorcontrib>Batchelor, Wayne B</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Current cardiology reviews</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tehrani, Behnam N</au><au>Damluji, Abdulla A</au><au>Batchelor, Wayne B</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Acute Myocardial Infarction and Cardiogenic Shock Interventional Approach to Management in the Cardiac Catheterization Laboratories</atitle><jtitle>Current cardiology reviews</jtitle><addtitle>Curr Cardiol Rev</addtitle><date>2022-03-01</date><risdate>2022</risdate><volume>18</volume><issue>2</issue><spage>e251121198293</spage><epage>e251121198293</epage><pages>e251121198293-e251121198293</pages><issn>1573-403X</issn><eissn>1875-6557</eissn><notes>ObjectType-Article-2</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-3</notes><notes>content type line 23</notes><notes>ObjectType-Review-1</notes><abstract>Despite advances in early reperfusion and a technologic renaissance in the space of Mechanical Circulatory Support (MCS), Cardiogenic Shock (CS) remains the leading cause of in-hospital mortality following Acute Myocardial Infarction (AMI). Given the challenges inherent to conducting adequately powered randomized controlled trials in this time-sensitive, hemodynamically complex, and highly lethal syndrome, treatment recommendations have been derived from AMI patients without shock. In this review, we aimed to (1) examine the pathophysiology and the new classification system for CS; (2) provide a comprehensive, evidence-based review for best practices for interventional management of AMI-CS in the cardiac catheterization laboratory; and (3) highlight the concept of how frailty and geriatric syndromes can be integrated into the decision process and where medical futility lies in the spectrum of AMI-CS care. Management strategies in the cardiac catheterization laboratory for CS include optimal vascular access, periprocedural antithrombotic therapy, culprit lesion versus multi-vessel revascularization, selective utilization of hemodynamic MCS tailored to individual shock hemometabolic profiles, and management of cardiac arrest. 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subjects | Aged Best practice Cardiac catheterization Cardiac Catheterization - adverse effects Catheterization Clinical trials Heart Heart attacks Hemodynamics Humans Intubation Laboratories Myocardial infarction Myocardial Infarction - complications Myocardial Infarction - therapy Patients Reperfusion Shock Shock, Cardiogenic - diagnosis Shock, Cardiogenic - etiology Shock, Cardiogenic - therapy Treatment Outcome |
title | Acute Myocardial Infarction and Cardiogenic Shock Interventional Approach to Management in the Cardiac Catheterization Laboratories |
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