SHould We Emergently Revascularize Occluded Coronaries for Cardiogenic ShocK: An international randomized trial of emergency PTCA/CABG—trial design

摘要: Background Cardiogenic shock (CS) is the leading cause of death in patients hospitalized with acute myocardial infarction (MI). Nonrandomized studies suggest reduced mortality rate revascularization. Trial design The SHOCK trial a multicenter, randomized, and unblinded study Registry for trial-eligible ineligible nonrandomized patients. testing hypothesis that direct invasive strategy emergency revascularization cardiogenic complicating MI will reduce 30-day all-cause by 20 absolute percentage points compared initial medical stabilization. Eligibility criteria include development CS within 36 hours an transmural as evidenced ST elevation or new left bundle branch block MI; clinical hemodynamic confirmation; absence mechanical, iatrogenic, other shock; enrollment 12 diagnosis. Patients randomly assigned to immediately undergo coronary angiography, percutaneous transluminal angioplasty artery bypass grafting depending on anatomy stabilization may greater than equal 54 after randomization. End primary end point Secondary at termination, changes ventricular dimensions function measured echocardiography randomization 2 weeks later, quality rife physical functioning from discharge 6 months MI.