TCT-260 Multivessel Versus Culprit-Vessel Percutaneous Coronary Intervention in Patients With Acute Myocardial Infarction with Cardiogenic Shock
Recommended Citation
Lemor A, Zhao D, Truesdell A, Bharadwaj A, Falah B, Gorgis S, Hanson I, Schonning M, Burkhoff D, Lansky A, O'Neill WW. TCT-260 Multivessel Versus Culprit-Vessel Percutaneous Coronary Intervention in Patients With Acute Myocardial Infarction with Cardiogenic Shock. J Am Coll Cardiol 2025; 86(17):B113-B114.
Document Type
Conference Proceeding
Publication Date
10-28-2025
Publication Title
J Am Coll Cardiol
Keywords
amikacin, acute heart infarction, cardiogenic shock, conference abstract, controlled study, female, heart arrest, hemodynamics, human, left ventricular assist device, major clinical study, male, observational study, percutaneous coronary intervention, revascularization, therapy
Abstract
Background: Culprit-shock established the benefit of culprit-only revascularization in acute myocardial infarction and cardiogenic shock (AMICS). Whether the use of percutaneous left ventricular assist devices (pLVAD) changes this paradigm remains unclear. Methods: This patient-level pooled analysis of RECOVER III (NCT04136392) and the National Cardiogenic Shock Initiative (NCT03677180)-both single-arm, multicenter, observational studies-enrolled patients with AMICS who underwent percutaneous coronary intervention (PCI) with pLVAD. Outcomes were compared between patients with multi-vessel (MV) disease undergoing MV PCI vs. culprit-vessel (CV) PCI. Patients who underwent left main PCI were excluded. Results: Among 369 patients with MV disease, 191 (51.8%) underwent MVPCI and 178 (48.2%) underwent CVPCI, with no significant differences in baseline characteristics. In-hospital survival was higher in patients undergoing MVPCI (63.4% vs. 52.2%, RR: 0.77 [0.60, 0.98], p=0.03). Thirty-day and 1-year survival favored MVPCI (57.7% vs. 48.2%, p=0.08, and 45.5% vs. 34.5%, p=0.059, respectively). In stage E shock, MVPCI improved in-hospital survival (54.8% vs. 39.4%, p=0.03). Notably, stage C/D had similar in-hospital survival irrespective of revascularization strategy (71.4% vs. 69.2%, p=0.75) (Table). [Formula presented] Conclusion: In patients with AMICS and MV disease treated with early pLVAD, MVPCI was associated with improved survival, especially in patients in Stage E shock. Randomized trials are needed to confirm the benefit of MVPCI in this population. Categories: CORONARY: Hemodynamic Support, Cardiogenic Shock and Cardiac Arrest
Volume
86
Issue
17
First Page
B113
Last Page
B114
