6/28/23, 12:23 AM CULPRIT-SHOCK (1 year follow-up) Pathway Feedback Search Clinical Topics Home Studies CULPRIT SHOCK 1 year follow-up) CULPRIT SHOCK 1 year follow-up) Disease Disease Disease Cardiogenic shock Non-ST-elevation myocardial inf ST-elev Trial question What is the role of the PCI of the culprit lesion among patients with acute myocardial infarction and cardiogenic shock? Study design Multi-center Open label RCT Population Characteristics of study participants 23.7% female N = 706 76.3% male 706 patients (161 female, 524 male) Inclusion criteria: patients who had acute myocardial infarction that was complicated by cardiogenic shock Key exclusion criteria: resuscitation for > 30 minutes, no intrinsic heart action, an assumed severe deficit in cerebral function with fixed dilated pupils, a mechanical cause of cardiogenic shock, the onset of shock > 12 hours before randomization Interventions N=344 culprit-lesion-only PCI (treatment of the culprit lesion with all other lesions left untreated at the time of the initial procedure) N=342 multivessel PCI (treatment of the culprit lesion with all additional lesions, including chronic total occlusions) Primary outcome https://web.pathway.md/studies/recHJjwyzNsiep7CD 1/2 6/28/23, 12:23 AM CULPRIT-SHOCK (1 year follow-up) Pathway Death at 1 year follow-up 56.9 % 56.9 50 42.7 % 28.4 % 14.2 % No significant difference 0.0 % Culprit-lesion-only percutaneous coronary intervention Multivessel percutaneous coronary intervention No significant difference in death at 1 year follow-up (50% vs. 56.9%; RR 0.88, 95% CI 0.76 to 1.01) Secondary outcomes No significant difference in recurrent myocardial infarction at 1 year (1.7% vs. 2.1%; RR 0.85, 95% CI 0.29 to 2.5) No significant difference in death, recurrent infarction, or rehospitalization for HF at 1 year (55.2% vs. 59.5%; RR 0.87, 95% CI 0.93 to 1.06) Borderline significant decrease in death or recurrent infarction (50.9% vs. 58.4%; RR 0.87, 95% CI 0.76 to 1) Safety outcomes No significant differences in stroke, bleeding. Significant differences in rehospitalization for congestive HF (5.2% vs. 1.2%), repeat revascularization (32.3% vs. 9.4%). Conclusion In patients who had acute myocardial infarction that was complicated by cardiogenic shock, culprit-lesion-only PCI was not superior to multivessel PCI with respect to death at 1 year follow- up. Reference Holger Thiele, Ibrahim Akin, Marcus Sandri et al. One-Year Outcomes after PCI Strategies in Cardiogenic Shock. N Engl J Med. 2018 Nov 1;379(18):1699-1710. Open reference URL https://web.pathway.md/studies/recHJjwyzNsiep7CD 2/2