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Cardiogenic Shock is the Leading Cause of Death for Heart Attack Patients

ch enrolled 302 patients between 1993 and 1998 at 29 tertiary care centers. All patients were initially treated with medications and IABP to support the circulation and half received immediate angioplasty or bypass surgery. Patients in the medications arm of the trial could undergo angioplasty or bypass surgery at least two days later. One year after treatment, 47 percent of the patients who received the invasive treatments immediately were alive compared to 34 percent of those in the medications group.

Dr. Hochman hopes that more patients with cardiogenic shock will be treated aggressively and she sees some progress. In January the New York State Department of Health began a two-year experiment in which heart attack patients with severe shock would be analyzed separately from the public databases.

Already Dr. Hochman says that she has heard from colleagues that more cardiogenic shock patients are undergoing angioplasty and surgery in New York because physicians aren’t worried about raising their publicly reported surgical and angioplasty mortality rates due to treating many shock patients.

The change was in response to a number of publications that suggested bias by New York physicians against doing invasive procedures in these highest risk patients. One study by Dr. Hochman and colleagues from Albert Einstein College of Medicine and New England Research Institutes showed that shock patients in New York were less likely than patients in other states to be treated aggressively, presumably because of public reporting requirements. The study’s findings were reported at a meeting last year of the American Heart Association.

Research is underway to find new treatments for cardiogenic shock. Dr. Hochman is leading a trial to determine whether a compound called nitric oxide synthase inhibitor can help shock patients by targeting excess nitric oxide production.

(Source: Newswie)
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