PMID- 16022953
OWN - NLM
STAT- MEDLINE
DCOM- 20050805
LR  - 20101118
IS  - 0735-1097 (Print)
IS  - 0735-1097 (Linking)
VI  - 46
IP  - 2
DP  - 2005 Jul 19
TI  - Functional status and quality of life after emergency revascularization for 
      cardiogenic shock complicating acute myocardial infarction.
PG  - 266-73
AB  - OBJECTIVES: Our goal was to describe the functional status of cardiogenic shock 
      survivors, identify the correlates of cardiogenic shock, and compare global 
      quality of life and functional status of patients randomly assigned to treatment 
      with emergency revascularization (ERV) versus initial medical stabilization 
      (IMS). BACKGROUND: Historically, the hospital survival rate of patients with 
      cardiogenic shock complicating acute myocardial infarction (MI) has been very 
      low. Shock survivors are salvaged from a critically ill state, and their later 
      functional status is not well documented. The SHould we emergently revascularize 
      Occluded Coronaries for cardiogenic shocK (SHOCK) trial showed significantly 
      improved one-year survival after ERV compared with IMS. METHODS: The SHOCK trial 
      survivors completed interviews at 2 weeks after discharge and at 6 and 12 months 
      after MI. Functional status assessment included the Multidimensional Index of 
      Life Quality and New York Heart Association (NYHA) congestive heart failure 
      functional class. RESULTS: Eighty-seven percent of one-year survivors of the 
      SHOCK trial were in NYHA functional class I or II. Between two weeks after 
      discharge and one year after MI, improvement was similar in the two treatment 
      groups (18% overall), but fewer patients remained stable (44% vs. 71%), and more 
      patients worsened or died (34% vs. 15%) in the IMS group compared with those 
      assigned to ERV. Assignment to ERV was the only independent predictor of outcome 
      at one year. CONCLUSIONS: Although one-year mortality after ERV is still high 
      (54%), most survivors have good functional status. The ERV patients have a lower 
      rate of deterioration than IMS patients. The level of recovery for shock patients 
      undergoing ERV is similar to that of historical controls not in cardiogenic shock 
      undergoing elective revascularization.
FAU - Sleeper, Lynn A
AU  - Sleeper LA
AD  - New England Research Institutes, Watertown, Massachusetts 02472, USA. 
      sleeper@neriscience.com
FAU - Ramanathan, Krishnan
AU  - Ramanathan K
FAU - Picard, Michael H
AU  - Picard MH
FAU - Lejemtel, Thierry H
AU  - Lejemtel TH
FAU - White, Harvey D
AU  - White HD
FAU - Dzavik, Vladimir
AU  - Dzavik V
FAU - Tormey, Deborah
AU  - Tormey D
FAU - Avis, Nancy E
AU  - Avis NE
FAU - Hochman, Judith S
AU  - Hochman JS
CN  - SHOCK Investigators
LA  - eng
GR  - R01 HL49970/HL/NHLBI NIH HHS/United States
GR  - R01 HL50020/HL/NHLBI NIH HHS/United States
PT  - Clinical Trial
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, U.S. Gov't, P.H.S.
PL  - United States
TA  - J Am Coll Cardiol
JT  - Journal of the American College of Cardiology
JID - 8301365
SB  - IM
CIN - J Am Coll Cardiol. 2005 Jul 19;46(2):274-6. PMID: 16022954
MH  - Angioplasty, Balloon, Coronary
MH  - Coronary Artery Bypass
MH  - Emergency Treatment
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Intra-Aortic Balloon Pumping
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*complications
MH  - *Myocardial Revascularization
MH  - *Quality of Life
MH  - Recovery of Function
MH  - Shock, Cardiogenic/etiology/mortality/*therapy
MH  - Survival Analysis
MH  - Survival Rate
MH  - Thrombolytic Therapy
MH  - Treatment Outcome
EDAT- 2005/07/19 09:00
MHDA- 2005/08/06 09:00
CRDT- 2005/07/19 09:00
PHST- 2004/11/04 00:00 [received]
PHST- 2005/01/07 00:00 [revised]
PHST- 2005/01/11 00:00 [accepted]
PHST- 2005/07/19 09:00 [pubmed]
PHST- 2005/08/06 09:00 [medline]
PHST- 2005/07/19 09:00 [entrez]
AID - S0735-1097(05)00902-2 [pii]
AID - 10.1016/j.jacc.2005.01.061 [doi]
PST - ppublish
SO  - J Am Coll Cardiol. 2005 Jul 19;46(2):266-73. doi: 10.1016/j.jacc.2005.01.061.