Research ExplorerPublicationsOne-Year Outcomes after PCI Strategies in Cardiogenic Shock

One-Year Outcomes after PCI Strategies in Cardiogenic Shock

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One-Year Outcomes after PCI Strategies in Cardiogenic Shock. / Thiele, Holger; Akin, Ibrahim; Sandri, Marcus; de Waha-Thiele, Suzanne; Meyer-Saraei, Roza; Fuernau, Georg; Eitel, Ingo; Nordbeck, Peter; Geisler, Tobias; Landmesser, Ulf; Skurk, Carsten; Fach, Andreas; Jobs, Alexander; Lapp, Harald; Piek, Jan J; Noc, Marko; Goslar, Tomaž; Felix, Stephan B; Maier, Lars S; Stepinska, Janina; Oldroyd, Keith; Serpytis, Pranas; Montalescot, Gilles; Barthelemy, Olivier; Huber, Kurt; Windecker, Stephan; Hunziker, Lukas; Savonitto, Stefano; Torremante, Patrizia; Vrints, Christiaan; Schneider, Steffen; Zeymer, Uwe; Desch, Steffen; CULPRIT-SHOCK Investigators.

In: NEW ENGL J MED, Vol. 379, No. 18, 01.11.2018, p. 1699-1710.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Thiele, H, Akin, I, Sandri, M, de Waha-Thiele, S, Meyer-Saraei, R, Fuernau, G, Eitel, I, Nordbeck, P, Geisler, T, Landmesser, U, Skurk, C, Fach, A, Jobs, A, Lapp, H, Piek, JJ, Noc, M, Goslar, T, Felix, SB, Maier, LS, Stepinska, J, Oldroyd, K, Serpytis, P, Montalescot, G, Barthelemy, O, Huber, K, Windecker, S, Hunziker, L, Savonitto, S, Torremante, P, Vrints, C, Schneider, S, Zeymer, U, Desch, S & CULPRIT-SHOCK Investigators 2018, 'One-Year Outcomes after PCI Strategies in Cardiogenic Shock', NEW ENGL J MED, vol. 379, no. 18, pp. 1699-1710. https://doi.org/10.1056/NEJMoa1808788

APA

Thiele, H., Akin, I., Sandri, M., de Waha-Thiele, S., Meyer-Saraei, R., Fuernau, G., Eitel, I., Nordbeck, P., Geisler, T., Landmesser, U., Skurk, C., Fach, A., Jobs, A., Lapp, H., Piek, J. J., Noc, M., Goslar, T., Felix, S. B., Maier, L. S., ... CULPRIT-SHOCK Investigators (2018). One-Year Outcomes after PCI Strategies in Cardiogenic Shock. NEW ENGL J MED, 379(18), 1699-1710. https://doi.org/10.1056/NEJMoa1808788

Vancouver

Thiele H, Akin I, Sandri M, de Waha-Thiele S, Meyer-Saraei R, Fuernau G et al. One-Year Outcomes after PCI Strategies in Cardiogenic Shock. NEW ENGL J MED. 2018 Nov 1;379(18):1699-1710. https://doi.org/10.1056/NEJMoa1808788

Bibtex

@article{680ea5470e85452b96d2a4697e07f7ee,
title = "One-Year Outcomes after PCI Strategies in Cardiogenic Shock",
abstract = "BACKGROUND: Among patients with acute myocardial infarction, cardiogenic shock, and multivessel coronary artery disease, the risk of a composite of death from any cause or severe renal failure leading to renal-replacement therapy at 30 days was found to be lower with percutaneous coronary intervention (PCI) of the culprit lesion only than with immediate multivessel PCI. We evaluated clinical outcomes at 1 year.METHODS: We randomly assigned 706 patients to either culprit-lesion-only PCI or immediate multivessel PCI. The results for the primary end point of death or renal-replacement therapy at 30 days have been reported previously. Prespecified secondary end points at 1 year included death from any cause, recurrent myocardial infarction, repeat revascularization, rehospitalization for congestive heart failure, the composite of death or recurrent infarction, and the composite of death, recurrent infarction, or rehospitalization for heart failure.RESULTS: As reported previously, at 30 days, the primary end point had occurred in 45.9% of the patients in the culprit-lesion-only PCI group and in 55.4% in the multivessel PCI group (P=0.01). At 1 year, death had occurred in 172 of 344 patients (50.0%) in the culprit-lesion-only PCI group and in 194 of 341 patients (56.9%) in the multivessel PCI group (relative risk, 0.88; 95% confidence interval [CI], 0.76 to 1.01). The rate of recurrent infarction was 1.7% with culprit-lesion-only PCI and 2.1% with multivessel PCI (relative risk, 0.85; 95% CI, 0.29 to 2.50), and the rate of a composite of death or recurrent infarction was 50.9% and 58.4%, respectively (relative risk, 0.87; 95% CI, 0.76 to 1.00). Repeat revascularization occurred more frequently with culprit-lesion-only PCI than with multivessel PCI (in 32.3% of the patients vs. 9.4%; relative risk, 3.44; 95% CI, 2.39 to 4.95), as did rehospitalization for heart failure (5.2% vs. 1.2%; relative risk, 4.46; 95% CI, 1.53 to 13.04).CONCLUSIONS: Among patients with acute myocardial infarction and cardiogenic shock, the risk of death or renal-replacement therapy at 30 days was lower with culprit-lesion-only PCI than with immediate multivessel PCI, and mortality did not differ significantly between the two groups at 1 year of follow-up. (Funded by the European Union Seventh Framework Program and others; CULPRIT-SHOCK ClinicalTrials.gov number, NCT01927549 .).",
keywords = "Aged, Female, Follow-Up Studies, Heart Failure/epidemiology, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Myocardial Infarction/complications, Patient Readmission, Percutaneous Coronary Intervention/methods, Recurrence, Renal Insufficiency/etiology, Renal Replacement Therapy, Shock, Cardiogenic/etiology",
author = "Holger Thiele and Ibrahim Akin and Marcus Sandri and {de Waha-Thiele}, Suzanne and Roza Meyer-Saraei and Georg Fuernau and Ingo Eitel and Peter Nordbeck and Tobias Geisler and Ulf Landmesser and Carsten Skurk and Andreas Fach and Alexander Jobs and Harald Lapp and Piek, {Jan J} and Marko Noc and Toma{\v z} Goslar and Felix, {Stephan B} and Maier, {Lars S} and Janina Stepinska and Keith Oldroyd and Pranas Serpytis and Gilles Montalescot and Olivier Barthelemy and Kurt Huber and Stephan Windecker and Lukas Hunziker and Stefano Savonitto and Patrizia Torremante and Christiaan Vrints and Steffen Schneider and Uwe Zeymer and Steffen Desch and {CULPRIT-SHOCK Investigators}",
year = "2018",
month = nov,
day = "1",
doi = "10.1056/NEJMoa1808788",
language = "English",
volume = "379",
pages = "1699--1710",
journal = "NEW ENGL J MED",
issn = "0028-4793",
publisher = "Massachussetts Medical Society",
number = "18",

}

RIS

TY - JOUR

T1 - One-Year Outcomes after PCI Strategies in Cardiogenic Shock

AU - Thiele, Holger

AU - Akin, Ibrahim

AU - Sandri, Marcus

AU - de Waha-Thiele, Suzanne

AU - Meyer-Saraei, Roza

AU - Fuernau, Georg

AU - Eitel, Ingo

AU - Nordbeck, Peter

AU - Geisler, Tobias

AU - Landmesser, Ulf

AU - Skurk, Carsten

AU - Fach, Andreas

AU - Jobs, Alexander

AU - Lapp, Harald

AU - Piek, Jan J

AU - Noc, Marko

AU - Goslar, Tomaž

AU - Felix, Stephan B

AU - Maier, Lars S

AU - Stepinska, Janina

AU - Oldroyd, Keith

AU - Serpytis, Pranas

AU - Montalescot, Gilles

AU - Barthelemy, Olivier

AU - Huber, Kurt

AU - Windecker, Stephan

AU - Hunziker, Lukas

AU - Savonitto, Stefano

AU - Torremante, Patrizia

AU - Vrints, Christiaan

AU - Schneider, Steffen

AU - Zeymer, Uwe

AU - Desch, Steffen

AU - CULPRIT-SHOCK Investigators

PY - 2018/11/1

Y1 - 2018/11/1

N2 - BACKGROUND: Among patients with acute myocardial infarction, cardiogenic shock, and multivessel coronary artery disease, the risk of a composite of death from any cause or severe renal failure leading to renal-replacement therapy at 30 days was found to be lower with percutaneous coronary intervention (PCI) of the culprit lesion only than with immediate multivessel PCI. We evaluated clinical outcomes at 1 year.METHODS: We randomly assigned 706 patients to either culprit-lesion-only PCI or immediate multivessel PCI. The results for the primary end point of death or renal-replacement therapy at 30 days have been reported previously. Prespecified secondary end points at 1 year included death from any cause, recurrent myocardial infarction, repeat revascularization, rehospitalization for congestive heart failure, the composite of death or recurrent infarction, and the composite of death, recurrent infarction, or rehospitalization for heart failure.RESULTS: As reported previously, at 30 days, the primary end point had occurred in 45.9% of the patients in the culprit-lesion-only PCI group and in 55.4% in the multivessel PCI group (P=0.01). At 1 year, death had occurred in 172 of 344 patients (50.0%) in the culprit-lesion-only PCI group and in 194 of 341 patients (56.9%) in the multivessel PCI group (relative risk, 0.88; 95% confidence interval [CI], 0.76 to 1.01). The rate of recurrent infarction was 1.7% with culprit-lesion-only PCI and 2.1% with multivessel PCI (relative risk, 0.85; 95% CI, 0.29 to 2.50), and the rate of a composite of death or recurrent infarction was 50.9% and 58.4%, respectively (relative risk, 0.87; 95% CI, 0.76 to 1.00). Repeat revascularization occurred more frequently with culprit-lesion-only PCI than with multivessel PCI (in 32.3% of the patients vs. 9.4%; relative risk, 3.44; 95% CI, 2.39 to 4.95), as did rehospitalization for heart failure (5.2% vs. 1.2%; relative risk, 4.46; 95% CI, 1.53 to 13.04).CONCLUSIONS: Among patients with acute myocardial infarction and cardiogenic shock, the risk of death or renal-replacement therapy at 30 days was lower with culprit-lesion-only PCI than with immediate multivessel PCI, and mortality did not differ significantly between the two groups at 1 year of follow-up. (Funded by the European Union Seventh Framework Program and others; CULPRIT-SHOCK ClinicalTrials.gov number, NCT01927549 .).

AB - BACKGROUND: Among patients with acute myocardial infarction, cardiogenic shock, and multivessel coronary artery disease, the risk of a composite of death from any cause or severe renal failure leading to renal-replacement therapy at 30 days was found to be lower with percutaneous coronary intervention (PCI) of the culprit lesion only than with immediate multivessel PCI. We evaluated clinical outcomes at 1 year.METHODS: We randomly assigned 706 patients to either culprit-lesion-only PCI or immediate multivessel PCI. The results for the primary end point of death or renal-replacement therapy at 30 days have been reported previously. Prespecified secondary end points at 1 year included death from any cause, recurrent myocardial infarction, repeat revascularization, rehospitalization for congestive heart failure, the composite of death or recurrent infarction, and the composite of death, recurrent infarction, or rehospitalization for heart failure.RESULTS: As reported previously, at 30 days, the primary end point had occurred in 45.9% of the patients in the culprit-lesion-only PCI group and in 55.4% in the multivessel PCI group (P=0.01). At 1 year, death had occurred in 172 of 344 patients (50.0%) in the culprit-lesion-only PCI group and in 194 of 341 patients (56.9%) in the multivessel PCI group (relative risk, 0.88; 95% confidence interval [CI], 0.76 to 1.01). The rate of recurrent infarction was 1.7% with culprit-lesion-only PCI and 2.1% with multivessel PCI (relative risk, 0.85; 95% CI, 0.29 to 2.50), and the rate of a composite of death or recurrent infarction was 50.9% and 58.4%, respectively (relative risk, 0.87; 95% CI, 0.76 to 1.00). Repeat revascularization occurred more frequently with culprit-lesion-only PCI than with multivessel PCI (in 32.3% of the patients vs. 9.4%; relative risk, 3.44; 95% CI, 2.39 to 4.95), as did rehospitalization for heart failure (5.2% vs. 1.2%; relative risk, 4.46; 95% CI, 1.53 to 13.04).CONCLUSIONS: Among patients with acute myocardial infarction and cardiogenic shock, the risk of death or renal-replacement therapy at 30 days was lower with culprit-lesion-only PCI than with immediate multivessel PCI, and mortality did not differ significantly between the two groups at 1 year of follow-up. (Funded by the European Union Seventh Framework Program and others; CULPRIT-SHOCK ClinicalTrials.gov number, NCT01927549 .).

KW - Aged

KW - Female

KW - Follow-Up Studies

KW - Heart Failure/epidemiology

KW - Humans

KW - Kaplan-Meier Estimate

KW - Male

KW - Middle Aged

KW - Myocardial Infarction/complications

KW - Patient Readmission

KW - Percutaneous Coronary Intervention/methods

KW - Recurrence

KW - Renal Insufficiency/etiology

KW - Renal Replacement Therapy

KW - Shock, Cardiogenic/etiology

U2 - 10.1056/NEJMoa1808788

DO - 10.1056/NEJMoa1808788

M3 - SCORING: Journal article

C2 - 30145971

VL - 379

SP - 1699

EP - 1710

JO - NEW ENGL J MED

JF - NEW ENGL J MED

SN - 0028-4793

IS - 18

ER -