Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843
Critical Care
Optimal Timing of Venoarterial-Extracorporeal Membrane Oxygenation in Acute Myocardial Infarction Patients Suffering From Refractory Cardiogenic Shock
Ki Hong Choi, Jeong Hoon Yang, David Hong, Taek Kyu Park, Joo Myung Lee, Young Bin Song, Joo-Yong Hahn, Seung-Hyuk Choi, Jin-Ho Choi, Su Ryeun Chung, Yang Hyun Cho, Dong Seop Jeong, Kiick Sung, Wook Sung Kim, Young Tak Lee, Hyeon-Cheol Gwon
Author information
Keywords: Acute myocardial infarction, Cardiogenic shock, Extracorporeal membrane oxygenation, Prognosis, Timing
JOURNAL OPEN ACCESS FULL-TEXT HTML
Supplementary material

2020 Volume 84 Issue 9 Pages 1502-1510

Editorial (84-9 pp. 1461-1463)
Browse “Advance online publication” version
Details
Full-text HTML Download PDF (1102K)
Download citation RIS

(compatible with EndNote, Reference Manager, ProCite, RefWorks)

BIB TEX

(compatible with BibDesk, LaTeX)

Text
How to download citation
Contact us
Abstract

Background:Although there is an increase in the use of mechanical circulatory support devices to rescue patients with acute myocardial infarction (AMI) complicated by refractory cardiogenic shock (CS), the optimal timing of the application remains controversial. Therefore, this study aimed to compare the clinical outcomes between venoarterial-extracorporeal membrane oxygenation (VA-ECMO) insertion before and after coronary revascularization in AMI patients with refractory CS.

Methods and Results:A total of 253 patients with AMI who underwent revascularization therapy with VA-ECMO were included. The study population was stratified into extracorporeal cardiopulmonary resuscitation (E-CPR) before revascularization (N=106, reference cohort) and refractory CS without E-CPR before revascularization (n=147, comparison cohort). Patients with refractory CS but without E-CPR before revascularization were further divided into VA-ECMO before revascularization (N=50) and VA-ECMO after revascularization (n=97). The primary endpoint was a composite of in-hospital mortality, left ventricular assist device implantation, and heart transplantation. The primary endpoint occurred in 60 patients (40.8%) of the comparison cohort and 51 patients (48.1%) of the reference cohort. Among the comparison cohort, the primary endpoint was significantly lower in VA-ECMO before revascularization than in VA-ECMO after revascularization (32.0% vs. 49.5%, OR 0.480, 95% CI 0.235–0.982, P=0.045). A similar trend was observed after a 1-year follow up.

Conclusions:Early initiation of VA-ECMO before revascularization therapy might improve clinical outcomes in patients with AMI complicated by refractory CS.

Content from these authors
© 2020 THE JAPANESE CIRCULATION SOCIETY

This article is licensed under a Creative Commons [Attribution-NonCommercial-NoDerivatives 4.0 International] license.
https://creativecommons.org/licenses/by-nc-nd/4.0/
Previous article Next article
Favorites & Alerts

Recently viewed articles
Predecessor

The Nippon Journal of Clinical Angio-Cardiology

Japanese Circulation Journal

JAPANESE CIRCULATION JOURNAL

Related information

Request a Permission

Related journals
Circulation Reports
Share this page
feedback
 Top