TY - JOUR JO - EuroIntervention TI - Angiographic predictors of outcome in myocardial infarction patients presenting with cardiogenic shock: A CULPRIT-SHOCK angiographic substudy AB - Aims: To determine the prognostic impact of pre and post-PCI TIMI Flow Grade (TIMI) and TIMI Myocardial Perfusion (TMPG) in a well-defined group of patients with cardiogenic shock due to acute myocardial infarction. <br />Methods and results: Patients with infarct-related cardiogenic shock randomized into the CULPRIT-SHOCK trial were included in the angiographic predictor analysis whenever their TIMI or TMPG was available in the Corelab database (96.9% of cases). A multivariable logistic regression analysis, adjusted on non-angiographic covariates, was performed to investigate if TIMI or TMPG, were independently associated with all-cause mortality or renal replacement therapy up to 1 year. Pre-PCI TIMI and TMPG did not impact mortality. When analyzed in separate multivariable models, post-PCI TIMI 3 and TMPG grade 3 were both significantly associated with reduced risk of 30-day mortality: aOR 0.61 (95%CI: 0.38-0.97, p=0.037) and 0.46 (95%CI: 0.29-0.72, p&lt;0.001), respectively. When considered in the same multivariable model, only TMPG was significantly associated with 30-day mortality (aOR 0.38 [0.20-0.71], p=0.002), 30-day composite of all-cause mortality and renal replacement therapy (aOR 0.34 [0.18-0.66], p=0.001) and mortality at 1-year follow-up (aOR 0.46 [0.24-0.88], p=0.02). <br />Conclusions: Post-PCI TIMI and TMPG are associated with mortality after PCI. TMPG is a better discriminator, supporting microcirculation rather than epicardial reperfusion for prognosis estimation. AU - Overtchouk Pavel AU - Barthelemy Olivier AU - Hauguel-Moreau Marie AU - Guedeney Paul AU - Rouanet Stéphanie AU - Zeitouni Michel AU - Silvain Johanne AU - Collet Jean-Philippe AU - Vicaut Eric AU - Zeymer Uwe AU - Desch Steffen AU - Thiele Holger AU - Montalescot Gilles AU - Bertin Benjamin AU - Brugier Delphine AU - Vignolles Nicolas AU - Hage Georges AU - El Kasty Mohamad AU - Kerneis Mathieu AU - Huber Kurt AU - Sandri Marcus AU - Noc Marko AU - Fuernau Georg VL - IS - Y1 - 07/07/2020 Y1 - 2020 DOI - 10.4244/EIJ-D-20-00139 SP - KW - acs / nste-acs KW - stemi KW - cardiogenic shock PB - Europa Digital & Publishing UR - https://eurointervention.pcronline.com/article/angiographic-predictors-of-outcome-in-myocardial-infarction-patients-presenting-with-cardiogenic-shock-a-culprit-shock-angiographic-substudy SN - 1774-024X ER -