CULPRIT-SHOCK
Culprit-Lesion-Only versus Multivessel PCI in Cardiogenic Shock
Patient / Population Intervention / Exposition Comparaison Critère de jugement
In 706 patients with multivessel disease and cardiogenic shock, culprit-only PCI with staged completion reduced 30-day death or RRT compared with immediate multivessel PCI.
N
706
Schéma
Multicentre RCT, Europe
Critère
30-day composite of death or renal-replacement therapy
Pertinence
1
Résultat45.9% vs 55.4% (RR 0.83; p=0.01). 1-y mortality similar; more rehospitalisation/repeat revascularisation in culprit-only.
Thiele H, et al. N Engl J Med. 2017;377(25):2419-2432. 10.1056/NEJMoa1710261
Discussion et critique
Settled an old debate: in shock, treat the culprit and stage the rest.