Amin Daoulah, Rishard Abdul, Ahmed F. Elmahrouk, Wael Almahmeed, Hatem Aloui, Mohammed Alshehri, Abdulrahman Arabi, Prashanth Panduranga, Nooraldaem Yousif, Amr A. Arafat, Mohammed A. Qutub, Waleed Alharbi, Rajesh Rajan, Mokhtar Abdirahman Kahin, Abdullah Al‐Enezi, Said Al Maashani, Taher Hassan, Jassim Alswuaidi, Ali Alshehri, Mubarak Aldossari, Sultan Mohammed Al Jarallah, Abdelmaksoud Elganady, Badr Alzahrani, Abdulrahman M. Alqahtani, Faisal Omar M. Al Nasser, Husam A. Noor, Mohamed Mohammednabil A. Alama, Alaa Aldossari, Sultan Alobaikan, Alsayed Ali Almarghany, Omar Kanbr, Ahmed A. Jamjoom, Youssef Elmahrouk, Ibrahim A. M. Abdulhabeeb, Mohammed Balghith, Ahmad Hersi, Gladsy Selva Livingston, Harvey Antony, Adnan Fathey Hussien, Abdulrahman Almoghairi, Mohamed Mohammednabil A. Alama, Mohamed Ajaz Ghani, Hazim Rahbi, Ayman Basardah, Bandar Alshehri, Abdulhadi Alama, Laura AlObaid, Seraj Abualnaja, Tarique Shahzad Chachar, Hassan Khan, Shahrukh Hashmani, Ahmed A. Ghonim, Khaled Almerri, Razan waleed W Alsofayan, Abdelaziz Tawengi, Abeer M. Shawky, Mohamed Alrefai, Islam Abdelmoneim Ahmed, Amir Lotfi
The role of invasive hemodynamic monitoring on the outcomes of cardiogenic shock in patients with acute myocardial infarction (AMI-CS) is controversial. We evaluated whether invasive hemodynamic monitoring improved in-hospital mortality in patients with AMI-CS. This study analyzed 1513 patients with AMI-CS presenting between 2020 and 2022. Patients were classified into 2 groups on the basis of invasive monitoring. Patients receiving invasive hemodynamic monitoring (n = 602) were more likely to present with advanced cardiogenic shock stages, cardiac arrest, bradyarrhythmias, and required more mechanical ventilation and renal support. Propensity score identified 488 matched pairs. Escalation of mechanical support was greater in patients who received noninvasive monitoring (14% vs 7%; P < .001). There was no difference in mortality among the matched patients (49.0% vs 49.182%, P > .99). Hospital stay was longer in patients who received invasive monitoring (median 7 vs 6 days; P = .016). In patients receiving invasive monitoring, the cardiac index, pulmonary artery capillary wedge pressure, and right atrial pressure and the use of Swan-Ganz did not predict mortality. In AMI-CS, invasive hemodynamic monitoring was not associated with improved outcomes compared with routine monitoring. These findings highlight the inconsistent evidence surrounding monitoring methods, underscoring the need for further research to inform clinical decision-making.