循環器ジャーナル70巻4号

2022年10月発行

特集 循環器救急診療・集中治療を極める Ⅶ．ショックを集中治療する

—心原性ショック②—急性冠症候群

著者： 田口裕哉¹ 伊藤智範²

所属機関： ¹岩手医科大学内科学講座循環器内科分野 ²岩手医科大学医学教育学講座地域医療学

ページ範囲：P.644 - P.652

Point
・心原性ショックを合併したACSは，冠動脈インターベンションが進歩した現代でも予後不良である．
・病状は経時的に変化することが多く，ショック進行の徴候を見逃さず早期に治療介入する．
・アルゴリズムを用いて適切に補助循環を使用することが，予後改善につながる可能性がある．

参考文献

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2）Ouweneel DM, Eriksen E, Sjauw KD, et al : Percutaneous Mechanical Circulatory Support Versus Intra-Aortic Balloon Pump in Cardiogenic Shock After Acute Myocardial Infarction. J Am Coll Cardiol 69 : 278-287, 2017

3）Rathore SS, Curtis JP, Chen J, et al : Association of door-to-balloon time and mortality in patients admitted to hospital with ST elevation myocardial infarction : national cohort study. BMJ 338 : b1807, 2009

4）Chioncel O, Parissis J, Mebazaa A, et al : Epidemiology, pathophysiology and contemporary management of cardiogenic shock-a position statement from the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail 22 : 1315-1341, 2020

5）Baran DA, Grines CL, Bailey S, et al : SCAI clinical expert consensus statement on the classification of cardiogenic shock : This document was endorsed by the American College of Cardiology（ACC）, the American Heart Association（AHA）, the Society of Critical Care Medicine（SCCM）, and the Society of Thoracic Surgeons（STS）in April 2019. Catheter Cardiovasc Interv 94 : 29-37, 2019

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9）Thiele H, Zeymer U, Neumann FJ, et al : Intraaortic balloon support for myocardial infarction with cardiogenic shock. N Engl J Med 367 : 1287-1296, 2012

10）Sjauw KD, Engström AE, Vis MM, et al : A systematic review and meta-analysis of intra-aortic balloon pump therapy in ST-elevation myocardial infarction : should we change the guidelines? Eur Heart J 30 : 459-468, 2009

11）Basir MB, Schreiber TL, Grines CL, et al : Effect of Early Initiation of Mechanical Circulatory Support on Survival in Cardiogenic Shock. Am J Cardiol 119 : 845-851, 2017

12）Dhruva SS, Ross JS, Mortazavi BJ, et al : Association of Use of an Intravascular Microaxial Left Ventricular Assist Device vs Intra-aortic Balloon Pump With In-Hospital Mortality and Major Bleeding Among Patients With Acute Myocardial Infarction Complicated by Cardiogenic Shock. JAMA 323 : 734-745, 2020

13）Basir MB, Schreiber T, Dixon S, et al : Feasibility of early mechanical circulatory support in acute myocardial infarction complicated by cardiogenic shock : The Detroit cardiogenic shock initiative. Catheter Cardiovasc Interv 91 : 454-461, 2018

14）Basir MB, Kapur NK, Patel K, et al : Improved Outcomes Associated with the use of Shock Protocols : Updates from the National Cardiogenic Shock Initiative. Catheter Cardiovasc Interv 93 : 1173-1183, 2019

15）Thiele H, Akin I, Sandri M, et al : PCI Strategies in Patients with Acute Myocardial Infarction and Cardiogenic Shock. N Engl J Med 377 : 2419-2432, 2017

16）Lemor A, Basir MB, Patel K, et al : Multivessel Versus Culprit-Vessel Percutaneous Coronary Intervention in Cardiogenic Shock. JACC Cardiovasc Interv 13 : 1171-1178, 2020