Background: Patients with acute myocardial infarction (MI) and shock are at increased risk of mortality, we divided the managing strategies and also sought to determine whether the revascularization strategy of coronary arteries makes difference regarding to mortality.Methods: We prospectively analyzed sixty patients presented by ST elevation myocardial infarction and complicated by cardiogenic shock admitted to National Heart Institute CCU foe one year who had recent history of acute STEMI within 24 hours of onset of symptoms and complicated by cardiogenic shock. They were divided in to two groups: Group1 with cardiogenic shock received thrombolytic. Group2 has PCI with two Subgroups: PCI for only Culprit artery. Another had total revascularization. Hospital mortalities in all shocked patient were studied according to revascularization strategy
Results: We included 60 patients with a mean age of 59 years. Females were (36.7%). CA was present in 26.7%. Hospital mortality was 26.7% (16 out of the 60 patients included in the study 50% in group 1 and 20% in culprit only subgroup and only 10% in total revascularization subgroup). After adjustment, higher mortality was in patients with thrombolytic group compared to patients with revascularization.  Conclusions:Total revascularization, when the anatomy is favorable, is the better revascularization strategy regarding mortality rather than culprit only revascularization, but the worst outcome and mortality was with patients in thrombolytic group without intervention. Risk factors; Dyslipidemia, DM, history of CAD and LVEF%, Post PCI TIMI flow (< grade III), were all associated with high mortality.