BACKGROUND: Cardiogenic shock is the most common cause of in-hospital mortality after acute myocardial infarction. Despite improvement in coronary care, the in-hospital mortality rate of cardiogenic shock is very high in conventional conservative therapy. Recently, it was suggested that coronary angioplasty may reduce the mortality associated with cardiogenic shock. METHOD: Thirteen consecutive patients with cardiogenic shock who underwent coronary angioplasty were studied. Shock was not induced by mechanical complications, arrhythmia, hypovolemia and other reversible cause. We collected and analyzed the clinical, hemodynamic survivor groups. RESULTS: Of 13 patients, 11 had successful reperfusion of the infarct-related coronary artery and 2 had unsuccessful reperfusion. Of 11 patients with successful angioplasty, 8 survived at the time of hospital discharge. All patents with unsuccessful angioplasty died in the hospital. Therefore overall hospital survival rate was 62% and the rate increased to 73% in patients with successful reperfusion. Survivor and non-survivor groups in clinical, hemodynamic and angiographic variables were similar except systolic blood pressure and the presence of successful reperfusion. CONCLUSION: In patients with cardiogenic shock, the patency of infarct-related coronary artery was strongly associated with in-hospital mortality. This findings support aggressive interventional strategy in patient with cardiogenic shock complicating acute myocardial infarction.
Angioplasty ; Angioplasty, Balloon, Coronary* ; Arrhythmias, Cardiac ; Blood Pressure ; Coronary Vessels ; Hemodynamics ; Hospital Mortality ; Humans ; Hypovolemia ; Mortality ; Myocardial Infarction* ; Reperfusion ; Shock ; Shock, Cardiogenic* ; Survival Rate ; Survivors

BACKGROUND: Cardiogenic shock is the most common cause of in-hospital mortality after acute myocardial infarction. Despite improvement in coronary care, the in-hospital mortality rate of cardiogenic shock is very high in conventional conservative therapy. Recently, it was suggested that coronary angioplasty may reduce the mortality associated with cardiogenic shock. METHOD: Thirteen consecutive patients with cardiogenic shock who underwent coronary angioplasty were studied. Shock was not induced by mechanical complications, arrhythmia, hypovolemia and other reversible cause. We collected and analyzed the clinical, hemodynamic survivor groups. RESULTS: Of 13 patients, 11 had successful reperfusion of the infarct-related coronary artery and 2 had unsuccessful reperfusion. Of 11 patients with successful angioplasty, 8 survived at the time of hospital discharge. All patents with unsuccessful angioplasty died in the hospital. Therefore overall hospital survival rate was 62% and the rate increased to 73% in patients with successful reperfusion. Survivor and non-survivor groups in clinical, hemodynamic and angiographic variables were similar except systolic blood pressure and the presence of successful reperfusion. CONCLUSION: In patients with cardiogenic shock, the patency of infarct-related coronary artery was strongly associated with in-hospital mortality. This findings support aggressive interventional strategy in patient with cardiogenic shock complicating acute myocardial infarction.
Angioplasty ; Angioplasty, Balloon, Coronary* ; Arrhythmias, Cardiac ; Blood Pressure ; Coronary Vessels ; Hemodynamics ; Hospital Mortality ; Humans ; Hypovolemia ; Mortality ; Myocardial Infarction* ; Reperfusion ; Shock ; Shock, Cardiogenic* ; Survival Rate ; Survivors

Bi-phenotypic neoplasm refers to tumors derived from a common cancer stem cell with unique capability to differentiate histologically into two distinct tumor types. Bi-phenotypic hepatocellular carcinoma-cholangiocarcinoma (HCC-CC), although a rare tumor, is important for clinicians to recognize, since treatment options targeting both elements of the tumor are crucial. Imaging findings of bi-phenotypic HCC-CC are not specific and include features of both HCC and CC. A combination of imaging and immuno-histochemical analysis is usually needed to make the diagnosis.
CA-19-9 Antigen/metabolism ; Carcinoma, Hepatocellular/mortality/pathology/radiography ; Cholangiocarcinoma/mortality/pathology/radiography ; Humans ; Liver Neoplasms/mortality/pathology/*radiography ; Magnetic Resonance Imaging ; Phenotype ; Risk Factors ; Survival Analysis ; Tomography, X-Ray Computed ; alpha-Fetoproteins/analysis