Treating heart attack patients who have a life-threatening complication called cardiogenic shock with emergency angioplasty or bypass surgery greatly improves the long-term survival of these patients. New study results show that at 6 years, almost 33 percent of patients treated with one of these revascularization procedures survived compared to about 20 percent of those receiving intensive medical care to stabilize their condition. The same study had previously shown that emergency angioplasty or bypass surgery for heart attack patients with shock improves 6-month survival; the new analysis found that this life-saving benefit was sustained over time -- in some cases for as long as 11 years. According to the investigators, the benefit equals 130 lives saved per 1000 patients treated.
The Should We Emergently Revascularize Occluded Coronaries for Cardiogenic Shock (SHOCK) trial was funded by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health.
The SHOCK trial enrolled 302 heart attack patients with cardiogenic shock at 29 international sites. Investigators randomly assigned 152 patients to undergo either emergency angioplasty or bypass surgery (within 6 hours). Another 150 patients were assigned to receive intensive medical therapy including clot-busting drugs with possible revascularization after 54 hours.
"Early Revascularization and Long-term Survival in Cardiogenic Shock Complicating Acute Myocardial Infarction," by Judith Hochman, M.D. of the New York University School of Medicine, will be published in the June 7 issue of the Journal of the American Medical Association.
Patrice Desvigne-Nickens, M.D., leader of NHLBI's Cardiovascular Medicine Scientific Research Group, is available to comment on the SHOCK study's findings. Dr. Desvigne-Nickens can discuss the importance of applying these findings to the treatment of cardiogenic shock, the leading cause of death in patients hospitalized for heart attack. As many as 43,000 hospitalized heart attack patients in the U.S. develop cardiogenic shock.
To schedule interviews, call the NHLBI Communications Office at (301) 496-4236.