{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T10:28:25Z","timestamp":1790504905628,"version":"4.1.0"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"21","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,11,2]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">The randomized DOREMI (Dobutamine Compared to Milrinone) clinical trial evaluated the efficacy and safety of milrinone and dobutamine in patients with cardiogenic shock. Whether the results remain consistent when stratified by acute myocardial infarction remains unknown. In this substudy, we sought to evaluate differences in clinical management and outcomes of acute myocardial infarction complicated by cardiogenic shock (AMICS) versus non\u2010AMICS.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Patients in cardiogenic shock (n=192) were randomized 1:1 to dobutamine or milrinone. The primary composite end point in this subgroup analysis was all\u2010cause in\u2010hospital mortality, cardiac arrest, non\u2010fatal myocardial infarction, cerebrovascular accident, the need for mechanical circulatory support, or initiation of renal replacement therapy (RRT) at 30\u2010days. Outcomes were evaluated in patients with (n=65) and without (n=127) AMICS. The primary composite end point was significantly higher in AMICS versus non\u2010AMICS (hazard ratio [HR], 2.21; 95% CI, 1.47\u20133.30;\n              <jats:italic>P<\/jats:italic>\n              =0.0001). The primary end point was driven by increased rates of all\u2010cause mortality, mechanical circulatory support, and RRT. No differences in other secondary outcomes including cardiac arrest or cerebrovascular accident were observed. AMICS remained associated with the primary composite outcome, 30\u2010day mortality, and RRT after adjustment for age, sex, procedural contrast use, multivessel disease, and inotrope type.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">AMI was associated with increased rates of adverse clinical outcomes in cardiogenic shock along with increased rates of mortality and initiation of mechanical circulatory support and RRT. Contrast administration during revascularization likely contributes to increased rates of RRT. Heterogeneity of outcomes in AMICS versus non\u2010AMICS highlights the need to study interventions in specific subgroups of cardiogenic shock.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Registration<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique identifier: NCT03207165.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.121.021570","type":"journal-article","created":{"date-parts":[[2021,10,29]],"date-time":"2021-10-29T09:04:08Z","timestamp":1635498248000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":23,"title":["Implications of Myocardial Infarction on Management and Outcome in Cardiogenic Shock"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8570-6736","authenticated-orcid":false,"given":"Richard G.","family":"Jung","sequence":"first","affiliation":[{"name":"CAPITAL Research Group Division of Cardiology University of Ottawa Heart Institute Ottawa Ontario Canada"},{"name":"Faculty of Medicine University of Ottawa Ontario Canada"},{"name":"Department of Cellular and Molecular Medicine University of Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro","family":"Di Santo","sequence":"additional","affiliation":[{"name":"CAPITAL Research Group Division of Cardiology University of Ottawa Heart Institute Ottawa Ontario Canada"},{"name":"School of Epidemiology and Public Health University of Ottawa Ontario Canada"},{"name":"Division of Cardiology University of Ottawa Heart Institute Ottawa Ontario 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A.","family":"Marbach","sequence":"additional","affiliation":[{"name":"CAPITAL Research Group Division of Cardiology University of Ottawa Heart Institute Ottawa Ontario Canada"},{"name":"Division of Critical Care Tufts Medical Center Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taylor","family":"Gillmore","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brennan","family":"Mao","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordan","family":"Bernick","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Methods Centre University of Ottawa Heart Institute Ottawa 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