June 11, 2020

To the Editor,

Re: Kapur NK, Thayer KL, Zweck E. Cardiogenic Shock in the Setting of Acute Myocardial Infarction. Methodist Debakey Cardiovasc J. 2020;16(1):1621. doi:10.14797/mdcj-16-1-16

It was with great interest that I read the article by Kapur et al. titled Cardiogenic Shock in the Setting of Acute Myocardial Infarction. The material was quite helpful and thorough in detail. I am concerned regarding the information presented in Table 1 (page 16), wherein it notes that a new left bundle branch block (LBBB) is considered a STEMI equivalent. The American Heart Association STEMI guidelines removed the finding of a new LBBB from their guidelines in 2013 after studies demonstrated difficulties in determining age of the LBBB, low rates of culprit artery occlusion, and higher complication rates associated with utilizing this as criteria for cardiac catheterization.1,2 An observational cohort study by Chang et al. also showed no difference in the rate of acute myocardial infarction between new, old, or no LBBB.3

Of note, the table also references Scarbossa's criteria which should in fact reference Sgarbossa's criteria.