Primary PCI in Cardiogenic Shock and Out-of-Hospital Cardiac Arrest

INTRODUCTION There is no doubt that timely primary PCI represents a gold standard of reperfusion therapy in patients with acute ST-elevation myocardial infarction (STEMI). Despite advances in primary PCI, which significantly reduced hospital mortality of unselected STEMI population when compared to thrombolysis (1,2), highrisk subgroups with mortality exceeding 40% still remain. These include patients with STEMI and cardiogenic shock and patients with STEMI after resuscitated sudden cardiac arrest, especially if they remain comatose after reestablishment of spontaneous circulation (ROSC) (2) (Fig. 1).