Cardiogenic Shock: A Summary of the Randomized SHOCK Trial

Venu Menon, MD, Rupert Fincke, MD

CHF. 2003;9(1)

Conclusion

Although there was no benefit at 30 days, among patients in CS due to LV dysfunction associated with an ST elevation MI, a strategy of ERV was superior to IMS at 6 and 12 months of follow-up. Patients younger than 75 years of age benefited most, with 20 lives saved at 6 months per 100 patients treated. According to the results of the SHOCK trial, ERV is now a class I indication for this patient population in the ACC/AHA myocardical infarction guidelines.^[22] Mortality with CABG was similar to that with percutaneous intervention in this high-risk population.

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Table. Definition of Shock: Clinical and Hemodynamic Criteria
Cardiogenic shock: clinical criteria Systolic blood pressure <90 mm Hg for 30 minutes before inotropes/vasopressors, or vasopressors or IABP are required to maintain systolic blood pressure ≥90 mm Hg Evidence of decreased organ perfusion Heart rate ≥60 beats per minute (including paced rhythms)
Cardiogenic shock: hemodynamic criteria PCWP ≥15 mm Hg Cardiac index ≤2.2 L/min/m²

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Cardiogenic Shock: A Summary of the Randomized SHOCK Trial

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