A small, randomized study suggests that norepinephrine may be a better choice than epinephrine.
Cardiogenic shock (CS) occurs in as many as 10% of patients with ST-segment elevation myocardial infarction. In a double-blind, randomized, multicenter French study (NCT01367743), investigators compared epinephrine and norepinephrine for treatment of CS secondary to acute myocardial infarction that was successfully reperfused with percutaneous coronary intervention.
The 57 participants (mean age, 67) had persistent hypotension, low cardiac index, and evidence for tissue hypoperfusion. About half received a balloon pump, two thirds received concomitant dobutamine, and all but one patient was mechanically ventilated.
Over 72 hours, cardiac index and blood pressure differed little between the two groups. However, epinephrine was associated with …
Reviewing Author
DisclosuresConsultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo
EquityMicrointerventional Devices, Inc.
RoyaltiesUniversity of Pennsylvania
Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic
Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI
Leadership Positions in Professional SocietiesHeart Valve Collaboratory (Scientific Committee Member, Chair of the Publications Committee)
DisclosuresConsultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo
EquityMicrointerventional Devices, Inc.
RoyaltiesUniversity of Pennsylvania
Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic
Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI
Leadership Positions in Professional SocietiesHeart Valve Collaboratory (Scientific Committee Member, Chair of the Publications Committee)