Cardiac Power Output Predicts Death in Patients with Cardiogenic Shock

In the randomized SHOCK trial (N Engl J Med 1999; 341:625), acute-MI patients with cardiogenic shock had a significantly lower 6-month mortality rate with revascularization than with medical therapy, although both groups' rates were high (50% and 63%). Now, investigators have assessed hemodynamic correlates of mortality in 541 patients enrolled in the SHOCK registry but not in the trial. The authors discuss little about the differences between trial participants and these nonparticipants.

Hemodynamic measurements were taken 6 to 12 hours after shock diagnosis. Along with typical measurements, the researchers calculated (in 181 patients) cardiac power output (CPO), a novel hemodynamic measure based on a formula involving mean arterial pressur…