Key result
Early revascularization in elderly patients (≥75 years) with AMI complicated by cardiogenic shock was associated with lower mortality compared to late or no revascularization (adjusted RR 0.46; 95% CI 0.28-0.75; P=0.002).
Why the study?
Does early revascularization improve survival in elderly patients (≥75 years) with acute myocardial infarction complicated by cardiogenic shock?
Observational (n=865)
Does early revascularization improve survival in elderly patients (≥75 years) with acute myocardial infarction complicated by cardiogenic shock?
Effect estimate: RR 0.46 (95% CI 0.28-0.75)
Absolute Event Rate: 48% vs 81%
p-value: p=0.002
Early revascularization in elderly patients (≥75 years) with AMI complicated by cardiogenic shock is associated with significantly improved survival in registry data, suggesting a potential benefit despite the lack of benefit seen in the randomized SHOCK trial.
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May support early revascularization in selected elderly AMI shock patients; challenges SHOCK trial but leaves open need for RCTs.
Vladimír Džavík (2003) conducted an observational in Acute myocardial infarction complicated by cardiogenic shock (n=865). Early revascularization (<18 hours since onset of shock) vs. Later or no revascularization procedure was evaluated on In-hospital mortality (≥75 years group) (RR 0.46, 95% CI 0.28-0.75, p=0.002). Early revascularization in elderly patients (≥75 years) with AMI complicated by cardiogenic shock was associated with lower mortality compared to late or no revascularization (adjusted RR 0.46; 95% CI 0.28-0.75; P=0.002).
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