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Technical consideration in acute myocardial infarction with cardiogenic shock: A review of antithrombotic and PCI therapies.

Publication ,  Journal Article
Marquis-Gravel, G; Zeitouni, M; Kochar, A; Jones, WS; Sketch, MH; Rao, SV; Patel, MR; Ohman, EM
Published in: Catheter Cardiovasc Interv
April 1, 2020

In this review, we report a contemporary appraisal of the available evidence focusing on adjunctive antithrombotic therapy and technical aspects of percutaneous coronary interventions (PCI) in patients with acute myocardial infarction and cardiogenic shock (AMICS). Only few randomized trials have been conducted to evaluate the optimal arterial access choice, antithrombotic therapy, stent type, or the role of aspiration thrombectomy in this population. Observational data suggest that a transradial approach should be preferred for experienced operators, although knowledge and experience of transfemoral access is required to place any mechanical support device. In the absence of high-quality evidence to guide choice of the adjunctive antithrombotic drugs to support PCI in patients with AMICS, knowledge of the altered pharmacokinetics and pharmacodynamics in shock is required to inform decisions. Drug-eluting stents should be favored over bare-metal stents, and routine thrombectomy is not encouraged. Owing to the challenges inherent to the conduct of randomized trials in this acutely ill patient population, concerted multicenter, and international efforts are paramount to orchestrate the development of high-quality evidence to guide clinical practice.

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Published In

Catheter Cardiovasc Interv

DOI

EISSN

1522-726X

Publication Date

April 1, 2020

Volume

95

Issue

5

Start / End Page

924 / 931

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Thrombectomy
  • Shock, Cardiogenic
  • Risk Factors
  • Risk Assessment
  • Percutaneous Coronary Intervention
  • Myocardial Infarction
  • Humans
  • Hemodynamics
  • Fibrinolytic Agents
 

Citation

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Marquis-Gravel, G., Zeitouni, M., Kochar, A., Jones, W. S., Sketch, M. H., Rao, S. V., … Ohman, E. M. (2020). Technical consideration in acute myocardial infarction with cardiogenic shock: A review of antithrombotic and PCI therapies. Catheter Cardiovasc Interv, 95(5), 924–931. https://doi.org/10.1002/ccd.28455
Marquis-Gravel, Guillaume, Michel Zeitouni, Ajar Kochar, W Schuyler Jones, Michael H. Sketch, Sunil V. Rao, Manesh R. Patel, and E Magnus Ohman. “Technical consideration in acute myocardial infarction with cardiogenic shock: A review of antithrombotic and PCI therapies.Catheter Cardiovasc Interv 95, no. 5 (April 1, 2020): 924–31. https://doi.org/10.1002/ccd.28455.
Marquis-Gravel G, Zeitouni M, Kochar A, Jones WS, Sketch MH, Rao SV, et al. Technical consideration in acute myocardial infarction with cardiogenic shock: A review of antithrombotic and PCI therapies. Catheter Cardiovasc Interv. 2020 Apr 1;95(5):924–31.
Marquis-Gravel, Guillaume, et al. “Technical consideration in acute myocardial infarction with cardiogenic shock: A review of antithrombotic and PCI therapies.Catheter Cardiovasc Interv, vol. 95, no. 5, Apr. 2020, pp. 924–31. Pubmed, doi:10.1002/ccd.28455.
Marquis-Gravel G, Zeitouni M, Kochar A, Jones WS, Sketch MH, Rao SV, Patel MR, Ohman EM. Technical consideration in acute myocardial infarction with cardiogenic shock: A review of antithrombotic and PCI therapies. Catheter Cardiovasc Interv. 2020 Apr 1;95(5):924–931.
Journal cover image

Published In

Catheter Cardiovasc Interv

DOI

EISSN

1522-726X

Publication Date

April 1, 2020

Volume

95

Issue

5

Start / End Page

924 / 931

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Thrombectomy
  • Shock, Cardiogenic
  • Risk Factors
  • Risk Assessment
  • Percutaneous Coronary Intervention
  • Myocardial Infarction
  • Humans
  • Hemodynamics
  • Fibrinolytic Agents