Cardiogenic shock: on the search for a breakthrough in outcome?

摘要

Cardiogenic shock and treatment is the major topic of the current issue of Current Opinion in Critical Care. I am happy to serve as Guest Editor for this important topic. Cardiogenic shock is still the major cause of death in patients hospitalized for acute myocardial infarction. However, evidence is scare and since the publication of the SHOCK trial in 1999 by Hochman et al. [1-3] only little progress has been made. Since the publication of the SHOCK trial the only trial which has shown a mortality reduction is the CULPRIT-SHOCK trial comparing immediate multivessel percutaneous coronary intervention (PCI) versus culprit-lesion-only PCI in patients with multivessel coronary artery disease [4,5]. All other large-scale randomized trials have failed to show a benefit such as nitric oxyde synthase reduction or the intraaortic balloon pump [6-9].