Acute cardiac care & resuscitation
Clinical significance of residual ischaemia in acute myocardial infarction complicated by cardiogenic shock undergoing venoarterial–extracorporeal membrane oxygenation
Main finding · 1-year all-cause deathResult — go to the resultAdjusted hazard ratio 1.03 95% CI 1.01–1.05Authors' conclusion
In patients with AMI with refractory CS who underwent VA-ECMO, residual ischaemia was associated with an increased risk of 1-year mortality.
Study context
- Population
- Patients with acute myocardial infarction (AMI) and multivessel disease undergoing venoarterial-extracorporeal membrane oxygenation (VA-ECMO) for refractory cardiogenic shock
- Participants
- 408 patients
- Exposure
- Residual ischaemia by residual SYNTAX score
- rSS = 0n = 100reference
- 0 < rSS ≤ 8n = 136
- rSS > 8n = 172
- Outcome
- All-cause death
- Follow-up
- 1 year
Methodological detailspooled registries (RESCUE and SMC-ECMO)
- Pooled registries (RESCUE and SMC-ECMO)
Main finding
1-year all-cause death
Adjusted hazard ratio
1.03
95% CI 1.01–1.05
P = 0.003
By group
rSS
adjusted HR 1.03 (95% CI 1.01–1.05); P = 0.003
As reported in the abstract
Observational data: associations, not effects.
Further findings
Baseline SYNTAX score and 1-year all-cause death
- Baseline SYNTAX score not associated with risk of primary outcome
1-year all-cause death, high vs low delta SYNTAX score (stratified by rSS)
- No significant difference between high and low delta SYNTAX score groups
Original publication
Clinical significance of residual ischaemia in acute myocardial infarction complicated by cardiogenic shock undergoing venoarterial–extracorporeal membrane oxygenation. Eur Heart J Acute Cardiovasc Care. Published 3 May 2024. doi:10.
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