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Percutaneous coronary intervention for cardiogenic shock in the SHOCK trial

John G. Webb, MD, FACC^*,*, April M. Lowe, MS, Timothy A. Sanborn, MD, FACC, Harvey D. White, DSc, Lynn A. Sleeper, ScD, Ronald G. Carere, MD, FACC^*, Christopher E. Buller, MD, FACC^||, S. Chiu Wong, MD, FACC^¶, Jean Boland, MD^#, Vlad Dzavik, MD^**, Mark Porway, MD, FACC, Gordon Pate, MB^*, Geoffrey Bergman, MD, FACC^¶, Judith S. Hochman, MD, FACC for the SHOCK Investigators

^* St. Paul's Hospital, Vancouver, Canada
New England Research Institutes, Watertown, Massachusetts, USA
Evanston Northwestern Healthcare, Evanston, Illinois, USA
Green Lane Hospital, Auckland, New Zealand
^|| Vancouver General Hospital, Vancouver, Canada
^¶ New York Presbyterian, New York, New York, USA
^# CHR Citadelle, Liege, Belgium
^** Toronto General Hospital, Toronto, Canada
Baystate Medical Center, Springfield, Massachusetts, USA
Division of Cardiology, New York University School of Medicine, New York, New York, USA

View larger version (19K): [in a new window]   Figure 1 Flowchart of SHOCK Trial patients. CABG = coronary artery bypass graft surgery; PCI = percutaneous coronary intervention.

View larger version (14K): [in a new window]   Figure 2 Relationship of stent implantation in the culprit artery and one-year survival in SHOCK trial patients assigned to early revascularization and undergoing percutaneous coronary intervention.

View larger version (17K): [in a new window]   Figure 3 Relationship of final angiographic culprit artery Thrombolysis In Myocardial Infarction (TIMI) flow grade after percutaneous coronary intervention and 30-day survival in SHOCK trial patients assigned to early revascularization.

View larger version (25K): [in a new window]   Figure 4 Time trends in the interventional management of cardiogenic shock and one-year survival. A significant increase in the use of multivessel percutaneous coronary intervention (PCI) (p = 0.018), stents, and glycoprotein IIb/IIIa antagonists (both <0.001) was observed. One-year survival and PCI success rates were similar over time (p = 0.889 for survival and p = 0.128 for success).