Acute cardiac care & resuscitationMeta-analysis
Venoarterial extracorporeal membrane oxygenation in patients with infarct-related cardiogenic shock: an individual patient data meta-analysis of randomised trials
- Individual patient data meta-analysis of randomised trials
- prespecified subgroup analyses
Authors' conclusion
VA-ECMO did not reduce 30-day death rate compared with medical therapy alone in patients with infarct-related cardiogenic shock, and an increase in major bleeding and vascular complications was observed.
Study context
- Population
- Patients with infarct-related cardiogenic shock
- Participants
- 567 patients · 4 trials
- Comparison
- Early routine venoarterial extracorporeal membrane oxygenation (VA-ECMO) vs optimal medical therapy alone
- VA-ECMOn = 284
- Controln = 283reference
Pooled result
30-day death rate · 30 days
Odds ratio
0.93
95% CI 0.66–1.29
VA-ECMO vs Control
OR 0.93 (95% CI 0.66–1.29)
As reported in the abstract
Further pooled results
30-day death rate, prespecified subgroups
- Subgroups consistent; no benefit for VA-ECMO
- P for interaction ≥ 0.079
Safety
| Outcome | OR (95% CI) | |
|---|---|---|
| Major bleeding | 2.44 (1.55–3.84) | |
| Peripheral ischaemic vascular complications | 3.53 (1.70–7.34) | |
| 0.10.31310Odds ratio (log scale) |
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Venoarterial extracorporeal membrane oxygenation in patients with infarct-related cardiogenic shock: an individual patient data meta-analysis of randomised trials. Lancet. Published 26 August 2023. doi:10.1016/s0140-6736(23)01607-0
Summarised from the published abstract; every number is checked against it