{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T15:15:53Z","timestamp":1789398953836,"version":"build-2803163510"},"reference-count":49,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2021,1,27]],"date-time":"2021-01-27T00:00:00Z","timestamp":1611705600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Membranes"],"abstract":"<jats:p>Cardiogenic shock following acute myocardial infarction is associated with high mortality, substantially unchanged for the previous 20 years. Several approaches have been sought to achieve a therapeutic breakthrough, from myocardial revascularization strategies to the use of mechanical circulatory support. Many issues are, as yet, unresolved. Systemic inflammation seems to play a key role but is still lacking in effective therapies, and is potentially compounded by the death spiral of hypoperfusion and\/or artificial devices. In this review, a multitarget approach to cardiogenic shock following acute myocardial infarction is proposed.<\/jats:p>","DOI":"10.3390\/membranes11020087","type":"journal-article","created":{"date-parts":[[2021,1,27]],"date-time":"2021-01-27T12:20:26Z","timestamp":1611750026000},"page":"87","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Multitarget Approach to Cardiogenic Shock after Acute Myocardial Infarction: Extracorporeal Life Support (ECLS) and Beyond"],"prefix":"10.3390","volume":"11","author":[{"given":"Federico","family":"Pappalardo","sequence":"first","affiliation":[{"name":"Department of Anesthesia and Intensive Care, IRCCS ISMETT, UPMC Italy, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Malara","sequence":"additional","affiliation":[{"name":"Cardiothoracic Center, Department of Anesthesia and Intensive Care, Istituto Clinico Sant\u2019Ambrogio, 20149 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3150-399X","authenticated-orcid":false,"given":"Andrea","family":"Montisci","sequence":"additional","affiliation":[{"name":"Cardiothoracic Center, Department of Anesthesia and Intensive Care, Istituto Clinico Sant\u2019Ambrogio, 20149 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,1,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2231","DOI":"10.1016\/j.jacc.2018.08.1038","article-title":"Fourth Universal Definition of Myocardial Infarction (2018)","volume":"72","author":"Thygesen","year":"2018","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_2","unstructured":"Wilkins, E., Wilson, L., Wickramasinghe, K., Bhatnagar, P., Leal, J., Luengo-Fernandez, R., Burns, R., Rayner, M., and Townsend, N. (2017). European Cardiovascular Disease Statistics Edition, European Heart Network."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e011991","DOI":"10.1161\/JAHA.119.011991","article-title":"Cardiogenic Shock","volume":"8","author":"Vahdatpour","year":"2019","journal-title":"J. Am. Heart Assoc."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1177\/2048872617741735","article-title":"Contemporary trends in cardiogenic shock: Incidence, intra-aortic balloon pump utilisation and outcomes from the London Heart Attack Group","volume":"7","author":"Rathod","year":"2017","journal-title":"Eur. Heart J. Acute Cardiovasc. Care"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"664","DOI":"10.1002\/ejhf.1750","article-title":"Trends in cardiogenic shock complicating acute myocardial infarction","volume":"22","author":"Aissaoui","year":"2020","journal-title":"Eur. J. Heart Fail."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e007293","DOI":"10.1161\/CIRCINTERVENTIONS.118.007293","article-title":"Twenty-Year Trends in the Incidence and Outcome of Cardiogenic Shock in AMIS Plus Registry","volume":"12","author":"Hunziker","year":"2019","journal-title":"Circ. Cardiovasc. Interv."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"686","DOI":"10.1161\/CIRCULATIONAHA.106.613596","article-title":"Cardiogenic Shock","volume":"117","author":"Reynolds","year":"2008","journal-title":"Circulation"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e001214","DOI":"10.1136\/openhrt-2019-001214","article-title":"Contemporary trends in use of mechanical circulatory support in patients with acute MI and cardiogenic shock","volume":"7","author":"Helgestad","year":"2020","journal-title":"Open Hear."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1002\/ccd.28329","article-title":"SCAI clinical expert consensus statement on the classification of cardiogenic shock","volume":"94","author":"Baran","year":"2019","journal-title":"Catheter. Cardiovasc. Interv."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1002\/ccd.28707","article-title":"Application of the SCAI classification in a cohort of patients with cardiogenic shock","volume":"96","author":"Schrage","year":"2020","journal-title":"Catheter. Cardiovasc. Interv."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2057","DOI":"10.1161\/CIRCULATIONAHA.108.784215","article-title":"Long-Term Trends in the Incidence of Heart Failure After Myocardial Infarction","volume":"118","author":"Velagaleti","year":"2008","journal-title":"Circulation"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1161\/CIRCULATIONAHA.118.038201","article-title":"Intraaortic Balloon Pump in Cardiogenic Shock Complicating Acute Myocardial Infarction","volume":"139","author":"Thiele","year":"2019","journal-title":"Circulation"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2511","DOI":"10.1001\/jama.295.21.2511","article-title":"Early Revascularization and Long-term Survival in Cardiogenic Shock Complicating Acute Myocardial Infarction","volume":"295","author":"Hochman","year":"2006","journal-title":"JAMA"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1699","DOI":"10.1056\/NEJMoa1808788","article-title":"One-Year Outcomes after PCI Strategies in Cardiogenic Shock","volume":"379","author":"Thiele","year":"2018","journal-title":"N. Engl. J. Med."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Bauters, C., Dubois, E., Porouchani, S., Saloux, E., Fertin, M., De Groote, P., Lamblin, N., and Pinet, F. (2017). Long-term prognostic impact of left ventricular remodeling after a first myocardial infarction in modern clinical practice. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0188884"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1002\/ccd.27427","article-title":"Feasibility of early mechanical circulatory support in acute myocardial infarction complicated by cardiogenic shock: The Detroit cardiogenic shock initiative","volume":"91","author":"Basir","year":"2018","journal-title":"Catheter. Cardiovasc. Interv."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1002\/ccd.27540","article-title":"The five key \u201cingredients\u201d for improving outcomes in cardiogenic shock complicating acute myocardial infarction","volume":"91","author":"Brilakis","year":"2018","journal-title":"Catheter. Cardiovasc. Interv."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Kolte, D., Sardar, P., Khera, S., Zeymer, U., Thiele, H., Hochadel, M., Radovanovic, D., Erne, P., Hambraeus, K., and James, S. (2017). Culprit Vessel\u2013Only Versus Multivessel Percutaneous Coronary Intervention in Patients with Cardiogenic Shock Complicating ST-Segment\u2013Elevation Myocardial Infarction. Circ. Cardiovasc. Interv., 10.","DOI":"10.1161\/CIRCINTERVENTIONS.117.005582"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1161\/01.CIR.48.3.588","article-title":"Pathophysiology of Cardiogenic Shock","volume":"48","author":"Alonso","year":"1973","journal-title":"Circulation"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1315","DOI":"10.1002\/ejhf.1922","article-title":"Epidemiology, pathophysiology and contemporary management of cardiogenic shock\u2014A position statement from the Heart Failure Association of the European Society of Cardiology","volume":"22","author":"Chioncel","year":"2020","journal-title":"Eur. J. Heart Fail."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"737","DOI":"10.12688\/f1000research.11150.1","article-title":"Acute mechanical circulatory support for cardiogenic shock: The \u201cdoor to support\u201d time","volume":"6","author":"Esposito","year":"2017","journal-title":"F1000Research"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1161\/CIRCRESAHA.116.303577","article-title":"The Biological Basis for Cardiac Repair after Myocardial Infarction","volume":"119","author":"Prabhu","year":"2016","journal-title":"Circ. Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1097\/FJC.0000000000000717","article-title":"NLRP3 Inflammasome in Acute Myocardial Infarction","volume":"74","author":"Mauro","year":"2019","journal-title":"J. Cardiovasc. Pharmacol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.cophys.2017.09.001","article-title":"Cell biological mechanisms in regulation of the post-infarction inflammatory response","volume":"1","author":"Frangogiannis","year":"2018","journal-title":"Curr. Opin. Physiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1007\/s00063-012-0117-y","article-title":"Acute myocardial infarction and cardiogenic shock","volume":"107","author":"Prondzinsky","year":"2012","journal-title":"Med. Klin. Intensiv. Notfallmedizin"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"7639","DOI":"10.1038\/s41598-020-64702-0","article-title":"Cardiogenic shock elicits acute inflammation, delayed eosinophilia, and depletion of immune cells in most severe cases","volume":"10","author":"Cuinet","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1007\/s00392-007-0626-5","article-title":"Proinflammatory cytokines in acute myocardial infarction with and without cardiogenic shock","volume":"97","author":"Debrunner","year":"2008","journal-title":"Clin. Res. Cardiol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1016\/j.ejcts.2003.12.003","article-title":"Myocardial ischemia, stunning, inflammation, and apoptosis during cardiac surgery: A review of evidence","volume":"25","author":"Anselmi","year":"2004","journal-title":"Eur. J. Cardio-Thoracic Surg."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1371","DOI":"10.1016\/j.amjcard.2009.12.059","article-title":"Interleukin-1 Blockade With Anakinra to Prevent Adverse Cardiac Remodeling After Acute Myocardial Infarction (Virginia Commonwealth University Anakinra Remodeling Trial [VCU-ART] Pilot Study)","volume":"105","author":"Abbate","year":"2010","journal-title":"Am. J. Cardiol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1394","DOI":"10.1016\/j.amjcard.2013.01.287","article-title":"Effects of Interleukin-1 Blockade With Anakinra on Adverse Cardiac Remodeling and Heart Failure After Acute Myocardial Infarction [from the Virginia Commonwealth University-Anakinra Remodeling Trial (2) (VCU-ART2) Pilot Study]","volume":"111","author":"Abbate","year":"2013","journal-title":"Am. J. Cardiol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1660","DOI":"10.1016\/j.jacc.2020.08.011","article-title":"Inhibition of Interleukin-1\u03b2 and Reduction in Atherothrombotic Cardiovascular Events in the CANTOS Trial","volume":"76","author":"Everett","year":"2020","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1763","DOI":"10.1016\/j.jacc.2020.08.026","article-title":"Interleukin-1Beta and Risk of Premature Death in Patients with Myocardial Infarction","volume":"76","author":"Silvain","year":"2020","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/j.clinthera.2018.11.016","article-title":"Why Colchicine Should Be Considered for Secondary Prevention of Atherosclerosis: An Overview","volume":"41","author":"Nidorf","year":"2019","journal-title":"Clin. Ther."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1016\/j.jacc.2012.10.027","article-title":"Low-Dose Colchicine for Secondary Prevention of Cardiovascular Disease","volume":"61","author":"Nidorf","year":"2013","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1395","DOI":"10.1161\/CIRCULATIONAHA.115.017611","article-title":"Anti-Inflammatory Treatment With Colchicine in Acute Myocardial Infarction","volume":"132","author":"Deftereos","year":"2015","journal-title":"Circulation"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"2497","DOI":"10.1056\/NEJMoa1912388","article-title":"Efficacy and Safety of Low-Dose Colchicine after Myocardial Infarction","volume":"381","author":"Tardif","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1890","DOI":"10.1161\/CIRCULATIONAHA.120.050771","article-title":"Colchicine in Patients With Acute Coronary Syndrome","volume":"142","author":"Tong","year":"2020","journal-title":"Circulation"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"e006956","DOI":"10.1161\/CIRCOUTCOMES.120.006956","article-title":"Systemic Inflammatory Response Syndrome Is Associated With Increased Mortality Across the Spectrum of Shock Severity in Cardiac Intensive Care Patients","volume":"13","author":"Jentzer","year":"2020","journal-title":"Circ. Cardiovasc. Qual. Outcomes"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13054-016-1570-4","article-title":"The inflammatory response to extracorporeal membrane oxygenation (ECMO): A review of the pathophysiology","volume":"20","author":"Millar","year":"2016","journal-title":"Crit. Care"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.1056\/NEJMoa1707914","article-title":"Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease","volume":"377","author":"Ridker","year":"2017","journal-title":"N. Engl. J. Med."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1828","DOI":"10.1093\/eurheartj\/ehq220","article-title":"Shock in acute myocardial infarction: The Cape Horn for trials?","volume":"31","author":"Thiele","year":"2010","journal-title":"Eur. Heart J."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1111\/aor.13327","article-title":"Blood Purification With CytoSorb in Critically Ill Patients: Single-Center Preliminary Experience","volume":"43","author":"Febres","year":"2019","journal-title":"Artif. Organs"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"S653","DOI":"10.21037\/jtd.2017.10.128","article-title":"Extracorporeal membrane oxygenation and cytokine adsorption","volume":"10","author":"Datzmann","year":"2018","journal-title":"J. Thorac. Dis."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1002\/ejhf.668","article-title":"Concomitant implantation of Impella\u00ae on top of veno-arterial extracorporeal membrane oxygenation may improve survival of patients with cardiogenic shock","volume":"19","author":"Pappalardo","year":"2017","journal-title":"Eur. J. Heart Fail."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"2095","DOI":"10.1161\/CIRCULATIONAHA.120.048792","article-title":"Left Ventricular Unloading Is Associated With Lower Mortality in Patients With Cardiogenic Shock Treated With Venoarterial Extracorporeal Membrane Oxygenation","volume":"142","author":"Schrage","year":"2020","journal-title":"Circulation"},{"key":"ref_46","unstructured":"Banning, A.S., Adriaenssens, T., Berry, C., Bogaerts, K., Erglis, A., Distelmaier, K., Guagliumi, G., Haine, S., Kastrati, A., and Massberg, S. (2020). The EURO SHOCK Trial: Design, Aims and Objectives. EuroIntervention."},{"key":"ref_47","unstructured":"Thiele, H. (2021, January 20). Prospective Randomized Multicenter Study Comparing Extracorporeal Life Support Plus Optimal Medical Care Versus Optimal Medical Care Alone in Patients With Acute Myocardial Infarction Complicated by Cardiogenic Shock Undergoing Revascularization, Available online: https:\/\/clinicaltrials.gov\/ct2\/show\/NCT03637205."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1016\/j.ahj.2019.04.019","article-title":"Rationale and design of DanGer shock: Danish-German cardiogenic shock trial","volume":"214","author":"Udesen","year":"2019","journal-title":"Am. Heart J."},{"key":"ref_49","unstructured":"Combesa, A. (2021, January 20). Assessment of ECMO in Acute Myocardial Infarction with Non-reversible Cardiogenic Shock to Halt Organ Failure and Reduce Mortality (ANCHOR), Available online: https:\/\/clinicaltrials.gov\/ct2\/show\/NCT04184635."}],"container-title":["Membranes"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0375\/11\/2\/87\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:16:06Z","timestamp":1760159766000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0375\/11\/2\/87"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1,27]]},"references-count":49,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2021,2]]}},"alternative-id":["membranes11020087"],"URL":"https:\/\/doi.org\/10.3390\/membranes11020087","relation":{},"ISSN":["2077-0375"],"issn-type":[{"value":"2077-0375","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1,27]]}}}