ST-segment elevation myocardial infarction, cardiac arrest, and cardiogenic shock: an interventional triumvirate of opportunity.

Cardiogenic shock following myocardial infarction remains a significant clinical challenge. Newly reported 30-day mortality rates remain in the 40% range and are not affected by the use of intra-aortic balloon counterpulsation (1). Few cardiac conditions are more deadly. The major exception is patients who suffer cardiac arrest with their ST-segment elevation myocardial infarction (STEMI) and, once resuscitated, manifest cardiogenic shock. Garot et al. (2) from Paris have shown that such patients have a 6-month mortality of 67%. In this post–cardiac arrest population, multiple stepwise logistic regression analysis showed the