Pulmonary artery catheterization in acute myocardial infarction complicated by cardiogenic shock: A review of contemporary literature

Table 1 Studies evaluating outcomes with use of pulmonary artery catheter in patients with cardiogenic shock

Author (year)	Study type	Region/sites	Time period	n	Study population	Outcomes	Conclusion
Sotomi et al[22] (2014)	Prospective observational	Japan-multicenter	2007-2011	1004	ADHF	All-cause mortality	Decreased all-cause mortality in PAC cohort on ionotropic support or lower SBP
Sionis et al[6] (2020)	Prospective observational	Europe-multicenter	2010-2012	219	CS, hypotension or severe LCOS	30-d mortality	No mortality difference. CI, CPI, and SVI-predictors of 30-d mortality
Rossello et al[21](2017)	Prospective observational	Spain-single center	2005-2009	179	CS	Short- and long-term mortality	Lower long-term and short-term mortality
Hernandez et al[13] (2019)	Retrospective observational	United States-multicenter	2004-2014	9431944	ADHF and CS	Mortality	Lower mortality
Doshi et al[54] (2018)	Retrospective observational	United States-multicenter	2005-2014	842369	CS	In-hospital mortality	Lower mortality
Cohen et al[55] (1)(2005)	Retrospective observational	International-multicenter	–	26437	ACS	30-d mortality	Higher mortality
Gore et al[56](1987)	Retrospective observational	United States-multicenter	1975, 1978, 1981, 1984	3263	AMI	In-hospital and long-term mortality	No mortality difference
Vallabhajosyula et al[17](2020)	Retrospective observational	United States-multicenter	2000-2014	364001	AMI-CS	In-hospital mortality	No mortality difference
Zorzi et al[52] (2019)	Retrospective observational	Switzerland-single center	2008-2011	91	CS	Mortality	Increase in PAC in first 24 h
Garan et al[34](2020)	Retrospective observational	United States-multicenter	2016-2019	1414	CS	In-hospital mortality	Lower mortality
Cooper et al[57](2015)(3)	Retrospective observational	United States-single center	2002-2008	217	AMI	CS diagnosis	Echocardiography-based criteria can be used to accurately diagnose CS

ACS: Acute coronary syndrome; ADHF: Acute decompensated heart failure; AMI: Acute myocardial infarction; CI: Cardiac index; CS: Cardiogenic shock; CPI: Cardiac power index; HF: Heart failure; LCOS: Low cardiac output syndrome; PAC: Pulmonary artery catheterization; SBP: Systolic blood pressure; SVI: Stroke volume index.

Table 2 Current guidelines on pulmonary artery catheterization in cardiogenic shock

Guideline	Recommendation
2011 ACCF/AHA CABG[51]	Invasive hemodynamic monitoring with PAC is required before induction of anesthesia in patients with CS undergoing CABG (Class 1; level of evidence C)
2013 ACCF/AHA HF[52]	Invasive hemodynamic monitoring should be performed in patients with respiratory distress or impaired perfusion – when intracardiac filling pressures could not be determined from clinical assessment (Class 1; level of evidence C)
	Invasive hemodynamic monitoring is also recommended for patients with persistent acute HF symptoms despite empiric HF therapy adjusts and with one of following: (1) Systemic or pulmonary vascular resistance; or fluid status or perfusion is uncertain; (2) Low systolic blood pressure despite initial therapy; (3) Worsening renal function; (4) Candidate for pressor support; and (5) Candidate for MCS or heart transplant (Class IIa; level of evidence C)
The 2013 ISHLT MCS[53]	Patients undergoing procedure MCS device placement should have insertion of large-bore intra-venous line, arterial line, and pulmonary catheter for monitoring and intra-venous access (Class I; level of evidence B)
2016 ESC HF[11]	Routine invasive hemodynamic evaluation is not indicated for diagnosis of HF – PAC could be used in hemodynamically unstable patients with unknown mechanism of deterioration
	PAC could be used for acute HF who have refractory symptoms despite pharmacological treatment (Class IIb; level of evidence C)
	PAC along with right heart catheterization is recommended for evaluation of patients for MCS or heart transplantation (Class I; level of evidence C)
2017 SCAI/HFSA Invasive Hemodynamics[54]	Continuous hemodynamic monitoring is required for patients receiving MCS
	Continuous hemodynamic monitoring is used for withdrawal of MCS and pharmacologic support

ACCF: American College of Cardiology Foundation; AHA: American Heart Association; CABG: Coronary artery bypass grafting; CS: Cardiogenic shock; ESC: European Society of Cardiology; HF: Heart failure; HFSA: Heart Failure Society of America; ISHLT: International Society of Heart and Lung Transplantation; MCS: Mechanical circulatory support; PAC: Pulmonary artery catheter; SCAI: Society of Cardiovascular Angiography and Intervention.