Background We analysed consecutive patients with acute myocardial infarction complicated by cardiogenic shock (CS) who were enrolled into the CULPRIT-SHOCK randomized controlled trial (RCT) and those with exclusion criteria who were included into the accompanying registry. Methods In total, 1,075 patients with infarct-related CS were screened for CULPRIT-SHOCK in 83 specialised centres in Europe; 369 of them had exclusion criteria for the RCT and were enrolled into the registry. Patients were followed over 1-year. Results Mean age was 68 years and 260 (25 %) were women. 13.5 %, 30.9 %, and 55.6 % had 1-vessel, 2-vessel, and 3-vessel coronary artery disease (CAD), respectively. Significant left main (LM) coronary artery stenosis was present in 8.0 %. 54.2 % of the patients had cardiac arrest before admission. TIMI 3 patency of the infarct vessel after PCI was achieved in 83.6 % of all patients. Mechanical circulatory support was applied in one third of patients. Total mortality after 30 days and one year was 47.6 % and 52.9 %. Mortality after one year was highest in patients with LM coronary artery stenosis (63.5 %), followed by 3-vessel- (56.6 %), 2-vessel- (49.8 %), and 1-vessel-CAD (38.6 %), respectively. Mechanical complications were rare (21/1008; 2.1 %) but associated with a high mortality of 66.7 % after 1 year. Conclusions In specialised centres in Europe short- and long-term mortality of patients with infarct-related CS treated with an invasive strategy is still high and mainly depending on the extent of coronary artery disease. Therefore, there is still need for improvement of care to improve prognosis of infarct-related CS.

中文翻译：

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梗塞相关心源性休克的当前谱和结果：来自 CULPRIT-SHOCK 登记和随机对照试验的见解

背景我们分析了参加 CULPRIT-SHOCK 随机对照试验 (RCT) 的急性心肌梗死并发心源性休克 (CS) 的连续患者以及纳入随附登记的符合排除标准的患者。方法 在欧洲 83 个专业中心总共对 1,075 名梗塞相关 CS 患者进行了 CULPRIT-SHOCK 筛查；其中 369 名患者符合随机对照试验的排除标准，并被登记在册。对患者进行了一年多的随访。结果 平均年龄为 68 岁，其中 260 名 (25%) 为女性。分别有 13.5%、30.9% 和 55.6% 患有 1 支、2 支和 3 支冠状动脉疾病 (CAD)。 8.0% 的患者存在显着左主干 (LM) 冠状动脉狭窄。 54.2%的患者入院前出现心脏骤停。 PCI 后 83.6% 的患者实现了梗死血管的 TIMI 3 通畅。三分之一的患者应用了机械循环支持。 30 天和一年后的总死亡率分别为 47.6% 和 52.9%。 LM 冠状动脉狭窄患者一年后死亡率最高 (63.5 %)，其次是 3 支血管 (56.6 %)、2 支血管 (49.8 %) 和 1 支血管 CAD (38.6 %)。 。机械并发症很少见（21/1008；2.1%），但 1 年后死亡率高达 66.7%。结论 在欧洲的专业中心，接受侵入性策略治疗的梗死相关 CS 患者的短期和长期死亡率仍然很高，主要取决于冠状动脉疾病的程度。因此，仍然需要改进护理以改善梗死相关 CS 的预后。