Revascularization in Acute Myocardial Infarction and Cardiogenic Shock in the Era of Mechanical Circulatory Support.

This review summarizes contemporary evidence and evolving revascularization strategies for acute myocardial infarction-cardiogenic shock (AMI-CS). Despite prompt percutaneous coronary intervention (PCI) as the standard of care, AMI-CS continues to carry approximately 40% to 50% 30-day mortality. We discuss the ongoing debate of culprit-only versus multivessel PCI in shock (informed by the CULPRIT-SHOCK trial and registry data) and examine the role of mechanical circulatory support devices (eg, Impella and ECMO) in improving outcomes. New trial data (eg, DanGer Shock) and recent guideline changes are highlighted to guide interventional cardiologists in optimizing care for this high-risk population.