Coronary stenting in acute myocardial infarction complicated with cardiogenic shock

Aim. To assess immediate and long-term results of urgent coronary stenting in patients with cardiogenic shock. Material and methods. Twenty three patients (15 men, 8 women mean age 58 +/- 12 years) with myocardial infarction and cardiogenic shock treated with vasopressors and intraaortic balloon pumping (IABP). Culprit lesions were localized in left anterior descending and right coronary arteries in 16 and 7 cases, respectively. Prior to stenting 18 and 5 patients had TIMI grade 0 and 1 flow, respectively. Results. Stents (n=26, Seaquence and Ephesos, length 12-28 mm, diameter 2-3.5 mm) were successfully implanted in all patients after balloon predilation. After stenting TIMI grade 3 flow was achieved in 15 patients, 8 patients had TIMI-2 flow without angiographic signs of dissection or residual stenosis. There were 4 inhospital deaths and 19 patients (83%) were discharged. One angioplasty and 2 coronary artery bypass grafting procedures because of restenosis and reocclusion were successfully performed during first 4 months of follow-up. Conclusion. Urgent stenting combined with IABP was effective method of treatment of cardiogenic shock with 83% inhospital survival and 61% freedom from repeat revascularization.