Chiu F.-C.SHENG-NAN CHANGJOU-WEI LINHWANG, JUEY-JENJUEY-JENHWANGYIH-SHARNG CHEN2019-11-272019-11-2720090022-5223https://www.scopus.com/inward/record.uri?eid=2-s2.0-71649087240&doi=10.1016%2fj.jtcvs.2009.03.038&partnerID=40&md5=c292123e51166bf8523f4b527f91e0eehttps://scholars.lib.ntu.edu.tw/handle/123456789/434092Objective: The objective of this study was to find the best treatment strategy in patients who had acute coronary syndrome and ST-segment elevation myocardial infarction sustaining cardiogenic shock. Methods: Patients having cardiogenic shock owing to acute coronary syndrome and ST-segment elevation myocardial infarction who required hemodynamic support with intra-aortic balloon counterpulsation were retrospectively retrieved from the clinical information system in a tertiary medical center in Taiwan. A propensity score-based matching process was applied to find equalized groups with documented involvement of more than 2 coronary vessels who received percutaneous coronary intervention only (PCI only group) and who underwent subsequent coronary artery bypass graft surgery after percutaneous coronary intervention (PCI+CABG group). A logistic regression model was used to find the factors associated with 30-day mortality. Results: The propensity analysis identified 44 patients in the PCI only group (35 men, 65 ± 2 years, and 9?women, 75 ± 4 years) and the other 44 patients in the PCI+CABG group (31 men, 67 ± 2 years, and 13 women, 71 ± 2 years) who had comparable baseline characteristics. The 30-day mortality, 40.9% in the PCI only group and 20.5% in the PCI+CABG group, was positively associated with percutaneous coronary intervention only (odds ratio, 3.33; 95% confidence intervals, 1.14-10.0; P = .03), increased age (odds ratio, 1.06 for each year; 95% confidence intervals, 1.01-1.12; P = .01) and a need to use extracorporeal membrane oxygenation (odds ratio, 9.64; 95% confidence intervals, 2.19-42.4; P < .001). Conclusions: This study has shown the survival benefit of surgical intervention in high-risk patients with acute coronary syndrome or ST-segment elevation myocardial infarction who had cardiogenic shock after percutaneous coronary intervention. ? 2009 The American Association for Thoracic Surgery.[SDGs]SDG3acute coronary syndrome; adult; aged; aorta balloon; article; cardiogenic shock; clinical article; cohort analysis; confidence interval; controlled study; coronary artery bypass graft; coronary artery bypass surgery; counterpulsation; disease severity; extracorporeal oxygenation; female; heart infarction; hemodynamics; high risk patient; human; logistic regression analysis; male; medical information system; mortality; percutaneous coronary intervention; priority journal; retrospective study; scoring system; ST segment elevation; survival rate; Taiwan; tertiary health care; Acute Coronary Syndrome; Aged; Angioplasty, Transluminal, Percutaneous Coronary; Coronary Artery Bypass; Counterpulsation; Electrocardiography; Female; Humans; Male; Myocardial Infarction; Propensity Score; Retrospective Studies; Shock, Cardiogenicjournal article10.1016/j.jtcvs.2009.03.038196603782-s2.0-71649087240