Will CULPRIT-SHOCK change my practice? The CULPRIT-SHOCK trial: culprit lesion-only PCI vs. multivessel PCI in patients with acute myocardial infarction and cardiogenic shock

Q: What is the clinical evidence from this study?

Study design: RCT. Population: Acute myocardial infarction with cardiogenic shock and multivessel coronary artery disease (n=706). Intervention: Culprit lesion-only PCI vs. Immediate multivessel PCI. Primary outcome: Composite of death or renal replacement therapy at 30 days (RR 0.83, 95% CI 0.71 to 0.96, p=0.01).

Q: What does this research mean for the field?

Culprit lesion-only PCI significantly reduces the 30-day composite risk of death or renal replacement therapy compared to immediate multivessel PCI in patients with acute myocardial infarction and cardiogenic shock. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

Giovanna Sarno; Alaide Chieffo; Peter Ludman; Adam Witkowski; Christian Spaulding; Stefan James

doi:10.4244/eijy18m09_1

October 1, 2018EuroInterventionOpen Access

Will CULPRIT-SHOCK change my practice? The CULPRIT-SHOCK trial: culprit lesion-only PCI vs. multivessel PCI in patients with acute myocardial infarction and cardiogenic shock

View Full Paper

Ask AI

Bookmark

Share

Key result

Culprit lesion-only PCI cuts 30-day death or renal replacement therapy ~17% vs immediate multivessel PCI.

RR 0.83
95% CI 0.71 to 0.96
P=0.01
n=706

Study Design

Type

RCT (n=706)

Randomization

Randomly assigned

Multicenter

Yes

PICO

P

Population

706 patients with acute myocardial infarction, cardiogenic shock, and multivessel coronary artery disease followed for 30 days.

I

Intervention / Comparator

Culprit lesion-only PCI vs Immediate multivessel PCI

O

Primary Outcome

Composite of death or renal replacement therapy at 30 days — RR 0.83 (0.71 to 0.96), p=0.01

Main Result

Relative Risk: 0.83 (95% CI 0.71–0.96)

Absolute Event Rate: 45.9% vs 55.4%

p-value: p=0.01

Limitations

Mechanical circulatory support was used in only ~28% of patients, leaving it debatable whether higher use would improve outcomes.
The trial did not specify the presence of a chronic total occlusion as an exclusion criterion.

Ask about this paper

Answers are grounded in this paper and cite their sources.

Abstract

No abstract yet. The journal hasn't published one we can show.

Discussion

No takes yet. Share an insight, caveat, or question.

Cite This Study

Sarno et al. (2018) conducted an RCT in Acute myocardial infarction with cardiogenic shock and multivessel coronary artery disease (n=706). Culprit lesion-only PCI vs. Immediate multivessel PCI was evaluated on Composite of death or renal replacement therapy at 30 days (RR 0.83, 95% CI 0.71 to 0.96, p=0.01). Culprit lesion-only PCI significantly reduced the 30-day composite risk of death or renal replacement therapy compared to immediate multivessel PCI (RR 0.83).

synapsesocial.com/papers/6aa83cc6f592fc864c8ac737 https://doi.org/10.4244/eijy18m09_1

View Full Paper

Ask AI

Bookmark

Share

Will CULPRIT-SHOCK change my practice? The CULPRIT-SHOCK trial: culprit lesion-only PCI vs. multivessel PCI in patients with acute myocardial infarction and cardiogenic shock

Study Design

PICO

Main Result

Limitations

Ask about this paper

Abstract

Discussion

Cite This Study

Will CULPRIT-SHOCK change my practice? The CULPRIT-SHOCK trial: culprit lesion-only PCI vs. multivessel PCI in patients with acute myocardial infarction and cardiogenic shock

Study Design

PICO

Main Result

Limitations

Ask about this paper

Abstract

Discussion

Cite This Study

Keep reading

Keep reading