Vasoactive pharmacological management according to SCAI class in patients with acute myocardial infarction and cardiogenic shock

• Published in: PloS one 2022-01, Vol.17 (8), p.e0272279
• Main Authors: Nanna Louise Junker Udesen, Ole Kristian Lerche Helgestad, Jakob Josiassen, Christian Hassager, Henrik Frederiksen Højgaard, Louise Linde, Jesper Kjaergaard, Lene Holmvang, Lisette Okkels Jensen, Henrik Schmidt, Hanne Berg Ravn, Jacob Eifer Møller
• Format: Article
• Language: English
• ISSN: 1932-6203
• DOI: 10.1371/journal.pone.0272279

BackgroundVasoactive treatment is a cornerstone in treating hypoperfusion in cardiogenic shock following acute myocardial infarction (AMICS). The purpose was to compare the achievement of treatment targets and outcome in relation to vasoactive strategy in AMICS patients stratified according to the Society of Cardiovascular Angiography and Interventions (SCAI) shock classification.MethodsRetrospective analysis of patients with AMICS admitted to cardiac intensive care unit at two tertiary cardiac centers during 2010-2017 with retrieval of real-time hemodynamic data and dosages of vasoactive drugs from intensive care unit databases.ResultsOut of 1,249 AMICS patients classified into SCAI class C, D, and E, mortality increased for each shock stage from 34% to 60%, and 82% (p 65mmHg and venous oxygen saturation > 55% were reached in the majority of patients; however, more patients in SCAI class D and E had values below treatment targets within 24 hours (p