American Society of Hirudotherapy

Contemporary device management of cardiogenic shock following acute myocardial infarction

Review published in Heart failure reviews (2021)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Narrative reviewDrug DevelopmentSuleiman T et al. · Heart failure reviews, 2021

Abstract

Despite advances in the overall management of acute myocardial infarction (AMI), cardiogenic shock in the setting of AMI (CS-AMI) continues to be associated with poor patient outcomes. There are multiple devices that can be used in CS-AMI to support the failing circulation, although their utility in improving outcomes as compared with conventional pharmacotherapy of vasopressors and inotropes remains to be established. This contemporary review provides an update on the evidence base for each of these techniques. In CS-AMI, acute thrombotic occlusion of a major epicardial artery leads to hypoxia and myocardial ischaemia in the territory subtended by that vessel. The resultant regional dysfunction in myocardial contractility can severely compromise stroke volume and result in acute circulatory failure, systemic hypoperfusion, lactic acidosis, multi-organ failure and ultimately death.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Publication typeJournal ArticleReview
Indexed MeSH termsHeart-Assist DevicesHumansIntra-Aortic Balloon PumpingMyocardial InfarctionShock, CardiogenicStroke VolumeTreatment Outcome

Summary

Despite advances in the overall management of acute myocardial infarction (AMI), cardiogenic shock in the setting of AMI (CS-AMI) continues to be associated with poor patient outcomes.

Why This Matters for Hirudotherapy

This review provides an update on the evidence base for multiple devices used to support the failing circulation in cardiogenic shock complicating acute myocardial infarction (CS-AMI), comparing their utility against conventional pharmacotherapy of vasopressors and inotropes. The abstract describes the pathophysiology of CS-AMI, noting that acute thrombotic occlusion of a major epicardial artery can lead to circulatory failure, systemic hypoperfusion, lactic acidosis, multi-organ failure, and death, and that outcomes remain poor despite advances in management. This review makes no mention of leeches, hirudin, leech therapy, or the leech secretome. Caveat: it has no identifiable relevance to hirudotherapy or ASH's domain.

Citation

Contemporary device management of cardiogenic shock following acute myocardial infarction

Suleiman T et al. · Heart failure reviews, 2021

DOI

Added to ASH library: May 27, 2026 · Site last updated: June 18, 2026

This website provides educational information and does not constitute medical advice, diagnosis, or treatment recommendations. Medicinal leech therapy carries clinically meaningful risks and should be performed only by qualified clinicians under institutionally approved protocols. FDA 510(k) clearance for medicinal leeches is limited to specific indications; investigational and off-label discussions are labeled accordingly. For patient-specific guidance, consult a qualified healthcare provider.