# Culprit-interventie bij cardiogene shock met hartstilstand

*geplaatst 2023-03-28 · Algemeen · Journal of the American College of Cardiology · doi 10.1016/j.jacc.2023.01.029 · https://hartvaat.nl/2023/03/28/culprit-interventie-bij-cardiogene-shock-met-hartstilstand/*

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.

## English: Influence of Culprit Lesion Intervention on Outcomes in Infarct-Related Cardiogenic Shock With Cardiac Arrest.

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.

## Abstract (original, from the publication)

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).

Auteurs: 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

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Bron: Journal of the American College of Cardiology, https://doi.org/10.1016/j.jacc.2023.01.029. Bijgewerkt 2026-07-03T18:39:01Z. 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.