Outcome of patients aged ≥75 years in the SHould we emergently revascularize Occluded Coronaries in cardiogenic shocK (SHOCK) trial: Do elderly patients with acute myocardial infarction complicated by cardiogenic shock respond differently to emergent revascularization?
2005; Elsevier BV; Volume: 149; Issue: 6 Linguagem: Inglês
10.1016/j.ahj.2005.03.045
ISSN1097-6744
AutoresVladimír Džavík, Lynn A. Sleeper, Michael H. Picard, Timothy A. Sanborn, April M. Lowe, Ken Gin, Jorge Saucedo, John G. Webb, Venu Menon, James Slater, Judith S. Hochman,
Tópico(s)Cardiac Arrest and Resuscitation
ResumoIn the SHOCK trial, the group of patients aged >or=75 years did not appear to derive the mortality benefit from early revascularization (ERV) versus initial medical stabilization (IMS) that was seen in patients aged or=75 years and of their younger counterparts.Of the 56 enrolled patients aged >or=75 years, those assigned to ERV had lower LV ejection fraction at baseline than IMS-assigned patients (27.5% +/- 12.7% vs 35.6% +/- 11.6%, P = .051). In the elderly ERV and IMS groups, 54.2% and 31.3%, respectively, were women ( P = .105) and 62.5% and 40.6%, respectively, had an anterior infarction (P = .177). The 30-day mortality rate in the ERV group was 75.0% in patients aged >or=75 years and 41.4% in those aged or=75 years, similar to the 56.8% for patients aged <75 years.Overall, the elderly randomized to ERV did not have better survival than elderly IMS patients. Despite the strong association of age and death post-CS, elderly patients assigned to IMS had a 30-day mortality rate similar to that of IMS patients aged or=75 years of age, with acute myocardial infarction complicated by CS.
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