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Impact of thrombolysis, intra-aortic balloon pump counterpulsation, and their combination in cardiogenic shock complicating acute myocardial infarction: a report from the SHOCK Trial Registry

Timothy A. Sanborn, MD, FACC^*, Lynn A. Sleeper, ScD, Eric R. Bates, MD, FACC, Alice K. Jacobs, MD, FACC, Jean Boland, MD^||, John K. French, PhD, MBChB^¶, Jo Dens, MD, Vladimir Dzavik, MD^**, Sebastian T. Palmeri, MD, FACC, John G. Webb, MD, FACC, Mark Goldberger, MD, FACC, Judith S. Hochman, MD, FACC^|||| for the SHOCK Investigators

^* New York Presbyterian Hospital, Weill Medical College of Cornell University, New York, New York, USA
New England Research Institutes, Watertown, Massachusetts, USA
University of Michigan Medical Center, Ann Arbor, Michigan, USA
Boston Medical Center, Boston, Massachusetts, USA
^|| CHR Citadelle, Liège, Belgium
^¶ Green Lane Hospital, Auckland, New Zealand
Gasthuisberg University Hospital, Leuven, Belgium
^** University of Alberta Hospital, Edmonton, Alberta, Canada
Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
St. Paul’s Hospital, Vancouver, British Columbia, Canada
Montefiore Medical Center, Bronx, New York, USA
^|||| St. Luke’s–Roosevelt Hospital, New York, New York, USA

View larger version (21K): [in a new window]   Figure 1 In-hospital mortality rates of SHOCK Trial Registry patients with predominant left ventricular failure. Patients receiving thrombolytic therapy had significantly lower mortality than those not receiving thrombolytic therapy in the overall cohort (p = 0.005), and this benefit was independent of IABP use (interaction p = 0.126). There was a significant difference in in-hospital mortality among the 4 subsets of patients treated with thrombolysis with IABP, thrombolysis without IABP, IABP alone or neither. Treatments were selected by local physicians. In each of these subsets, patients who underwent revascularization had lower mortality than those who were not revascularized (p < 0.0002).