{"id":"d6013a09ee56","type":"article","url":"https://hartvaat.nl/2023/03/28/culprit-interventie-bij-cardiogene-shock-met-hartstilstand/","title":"Culprit-interventie bij cardiogene shock met hartstilstand","title_en":"Influence of Culprit Lesion Intervention on Outcomes in Infarct-Related Cardiogenic Shock With Cardiac Arrest.","category":"algemeen","category_label":"Algemeen","professions":["cardioloog"],"tags":["acuut-hartfalen","bradycardie","cardiogene-shock","myocardinfarct","percutane-coronaire-interventie","plotse-hartdood"],"journal":"Journal of the American College of Cardiology","doi":"10.1016/j.jacc.2023.01.029","source_url":"https://doi.org/10.1016/j.jacc.2023.01.029","authors":["Uwe Zeymer","Brunilda Alushi","Marko Noc","Mamas A Mamas","Gilles Montalescot","Georg Fuernau","Kurt Huber","Janine Poess","Suzanne de Waha-Thiele","Steffen Schneider","Taoufik Ouarrak","Steffen Desch","Alexander Lauten","Holger Thiele"],"significance":6,"published":"2023-03-28","source_date":"2023-03-28","image":"","kennis":["https://hartvaat.nl/kennis/coronairlijden/stemi/"],"congress":"","summary_en":"This analysis examined the role of culprit lesion intervention in cardiogenic shock complicated by cardiac arrest, showing that primary PCI remains beneficial even in the most critically ill resuscitated patients.","created":"2026-07-03T10:30:17Z","updated":"2026-07-03T18:39:01Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Analyse onderzocht de rol van culprit-laesieinterventie bij infarctgerelateerde cardiogene shock met hartstilstand. Primaire PCI verbeterde de overleving, maar de prognose bleef somber. Patiëntselectie voor agressieve interventie blijft cruciaal.","abstract_original":"BACKGROUND: Cardiac arrest (CA) is common in patients with infarct-related cardiogenic shock (CS). OBJECTIVES: The goal of this study was to identify the characteristics and outcomes of culprit lesion percutaneous coronary intervention (PCI) of patients with infarct-related CS stratified according to CA in the CULPRIT-SHOCK (Culprit Lesion Only PCI Versus Multivessel PCI in Cardiogenic Shock) randomized trial and registry. METHODS: Patients with CS with and without CA from the CULPRIT-SHOCK study were analyzed. All-cause death or severe renal failure leading to renal replacement therapy within 30 days and 1-year death were assessed. RESULTS: Among 1,015 patients, 550 (54.2%) had CA. Patients with CA were younger, more frequently male, had lower rates of peripheral artery disease, a glomerular filtration rate <30 mL/min, and left main disease, and they presented more often with clinical signs of impaired organ perfusion. The composite of all-cause death or severe renal failure within 30 days occurred in 51.2% of patients with CA vs 48.5% in non-CA patients (P = 0.39) and 1-year death in 53.8% vs 50.4% (P = 0.29), respectively. In a multivariate analysis, CA was an independent predictor of 1-year mortality (HR: 1.27; 95% CI: 1.01-1.59). In the randomized trial, culprit lesion-only PCI was superior to immediate multivessel PCI in patients both with and without CA (P for interaction = 0.6). CONCLUSIONS: More than 50% of patients with infarct-related CS had CA. These patients with CA were younger and had fewer comorbidities, but CA was an independent predictor of 1-year mortality. Culprit lesion-only PCI is the preferred strategy, both in patients with and without CA. (Culprit Lesion Only PCI Versus Multivessel PCI in Cardiogenic Shock [CULPRIT-SHOCK]; NCT01927549)."}