Reducing Mortality in Patients with Extensive Myocardial Infarction

In this issue of the Journal, Goldberg et al. have estimated the incidence of cardiogenic shock complicating acute myocardial infarction.1 Their study includes more than 4000 patients cared for over a 14-year period at hospitals in the Worcester, Massachusetts, metropolitan area. The data indicate that the incidence of cardiogenic shock complicating acute myocardial infarction remained relatively constant during this period, averaging 7.5 percent. In-hospital mortality rates did not improve between 1975 and 1988; during this time, 74 percent to 82 percent of the patients died.These results may not be surprising. Patients with cardiogenic shock generally have 40 percent . . .