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Comment & Response |

Redesigning Care for Patients With Acute Myocardial Infarction Complicated by Cardiogenic Shock The “Shock Team”

Arthur Reshad Garan, MD1; Ajay Kirtane, MD, SM1; Hiroo Takayama, MD, PhD2
[+] Author Affiliations
1Division of Cardiology, Department of Medicine, Columbia University, New York, New York
2Division of Cardiothoracic Surgery, Department of Surgery, Columbia University, New York, New York
JAMA Surg. 2016;151(7):684-685. doi:10.1001/jamasurg.2015.5514.
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To the Editor We read with great interest the Viewpoint by Tchantchaleishvili et al1 calling for organized statewide networks for the management of acute myocardial infarction–related cardiogenic shock. We applaud the authors’ insights into one of the major current challenges in cardiovascular care. Despite advances in the treatment of coronary artery disease and in the technology of mechanical circulatory support devices (MCSDs), patients with myocardial infarction complicated by cardiogenic shock still have mortality rates in the range of 40% to 50%.2 While no trial since the SHOCK (Should We Emergently Revascularize Occluded Coronaries for Cardiogenic Shock) trial3 has demonstrated a clear benefit to any intervention beyond early revascularization, observational data suggest that improved outcomes for patients with this disease have paralleled the use of MCSDs.2 The use of MCSDs for appropriately selected patients, in conjunction with early revascularization, represents one way to improve on the unacceptably high mortality rates.

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July 1, 2016
Amy G. Fiedler, MD; Tae H. Song, MD; David A. D’Alessandro, MD
1Division of Cardiac Surgery, Department of Surgery, Massachusetts General Hospital, Boston
JAMA Surg. 2016;151(7):685. doi:10.1001/jamasurg.2015.5517.
July 1, 2016
Vakhtang Tchantchaleishvili, MD; William Hallinan, RN, MS; H. Todd Massey, MD
1Division of Cardiac Surgery, University of Rochester Medical Center, Rochester, New York
JAMA Surg. 2016;151(7):685-686. doi:10.1001/jamasurg.2015.5498.
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