Key result
Case report describes rescue PCI with IABP for STEMI complicated by cardiogenic shock.
Why the study?
Initial fibrinolytic therapy restores normal flow in only about 50% to 60% of STEMI patients within 90 minutes, with lower success in elderly or cardiogenic shock patients, and limited data suggest rescue PCI may reduce risks after unsuccessful fibrinolysis.
Case Report (n=1)
This case report illustrates the potential utility of rescue PCI with IABP support in managing STEMI complicated by cardiogenic shock after failed fibrinolysis.
May support rescue PCI with IABP after failed fibrinolysis in STEMI shock; leaves open need for prospective trials before adoption.
Fibrinolytic therapy remains the most common initial therapy for ST-segment elevation myocardial infarction (STEMI) in the U.S. and worldwide. However, an initial fibrinolytic therapy restores normal flow in only about 50% to 60% of STEMI patients in 90 minutes, with even lower success rates in elderly patients or those with cardiogenic shock. Based on the limited data, rescue percutaneous coronary intervention (PCI) appears to reduce the risks of recurrent myocardial infarction and possibly death compared to conservative therapy for the patients following unsuccessful fibrinolytic therapy. Here, we present a case with STEMI complicated by cardiogenic shock undergoing rescue PCI under the support of intra-aortic balloon counterpulsation (IABP).
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Zhao Feng Li (2014) conducted a case report in STEMI complicated by cardiogenic shock (n=1). Rescue percutaneous coronary intervention (PCI) with intra-aortic balloon counterpulsation (IABP) was evaluated. Rescue percutaneous coronary intervention with intra-aortic balloon counterpulsation was described in a single case of STEMI complicated by cardiogenic shock.
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