Early Revascularization in Cardiogenic Shock — A Positive View of a Negative Trial

During the past two decades, revolutionary changes in our understanding of both the pathogenesis and the treatment of acute myocardial infarction have resulted in impressive gains in survival among patients hospitalized for this condition. The notable exception to the overall 25 to 35 percent relative reduction in early mortality that has occurred as a result of myocardial reperfusion1 is among patients in whom myocardial infarction is complicated by cardiogenic shock. Such patients make up 7 to 10 percent of the patients hospitalized for acute myocardial infarction. Characterized by hypotension and organ hypoperfusion, cardiogenic shock has an estimated mortality rate of . . .