Multivessel versus culprit lesion only percutaneous revascularization in patients with acute myocardial infarction complicated by cardiogenic shock

Heart attack with cardiogenic shock: European Multicenter study for better treatment

Cardiogenic shock complicating acute myocardial infarction represents a major European health care concern with mortality rates between 40-70%. The clinician is faced with the decision to either intervene only on the culprit lesion acutely responsible for the initiation of cardiogenic shock, or treat additional lesions considered hemodynamically significant but not acutely triggering the shock cascade as well. Current guidelines recommend percutaneous coronary intervention of all critical lesions. However, due to a lack of randomized trials, these recommendations are solely based on registry data and pathophysiological considerations. Aim of the randomized CULPRIT-SHOCK trial is therefore to compare immediate multivessel PCI (Percutaneous Coronary Intervention) versus culprit lesion only PCI in patients with AMI complicated by cardiogenic shock. For the study a total of 706 cardiogenic shock patients will be randomized in 11 European countries. CULPRIT-SHOCK is expected to clarify the role of different percutaneous revascularization strategies in patients with cardiogenic shock secondary to myocardial infarction and multivessel disease. Upon completion, CULPRIT-SHOCK will be the largest randomized controlled clinical trial in patients with cardiogenic shock ever conducted and will inform patients, health care providers, and decision-makers about which percutaneous revascularization strategy is most effective. The CULPRIT-SHOCK consortium consists of 18 partners with clinical and scientific knowledge. Project coordinator is Prof. Dr. Thiele (University of Luebeck). The trial started on 1st September 2013 and runs four years.


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