Revascularization among patients with acute myocardial infarction complicated by cardiogenic shock and impact of American College of Cardiology/American Heart Association guidelines

Using New York City hospital discharge data from 1995 to 2002, we examined revascularization use among patients who had acute myocardial infarction complicated by cardiogenic shock before and after publication of recommendations by the American College of Cardiology/American Heart Association (ACC/AHA). The modest increase in these procedures from 1995 to 1999 and from 2000 to 2002 most likely reflected a trend, not a response, to the ACC/AHA recommendation. Moreover, the increase appeared to have been due to more frequent admission of eligible patients to hospitals capable of the service, as opposed to increasing revascularization rates in hospitals capable of revascularization.