Predictors of Clinical Outcome After Early Veno-Arterial Extracorporeal Membrane Oxygenation in Cardiogenic Shock Complicating ST-Elevation Myocardial Infarction

J Invasive Cardiol. 2021 May;33(5):E329-E335.ABSTRACTOBJECTIVES: Despite increasing use of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) in patients with cardiogenic shock (CS) secondary to ST-segment elevation myocardial infarction (STEMI), a paucity of adequate evidence for this therapy remains. The aim of this single-center clinical registry study was to identify predictors of survival and discern the possible optimal time to initiate VA-ECMO in this cohort.METHODS AND RESULTS: Seventy-nine consecutive patients with CS complicating STEMI who received VA-ECMO support were included in this analysis. The primary endpoint was survival at 6 months after initiation of VA-ECMO. Mean age was 60 ± 11 years. Forty-six patients (58%) were successfully weaned from VA-ECMO and 30 patients (38%) could be discharged. Of these, 23 patients (29% of the overall population) survived up to 6-month follow-up. Multivariate analysis to identify determinants of survival showed no association between the time of CS onset to VA-ECMO start time and 6-month survival (P=.75). Glomerular filtration rate on admission (P
Source: The Journal of Invasive Cardiology - Category: Cardiology Authors: Source Type: research

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ConclusionsThe estimates of cost-effectiveness for CO-PCI vs. MV-PCI have been shown to change depending on the time horizon and type of economic evaluation performed. The results favoured a long-term horizon analysis for avoiding underestimation of QALY gains from the CO-PCI arm.
Source: The European Journal of Health Economics - Category: Health Management Source Type: research
We thank Dr. Jolobe for their kind comments and interest in our work evaluating the role of fibrinolysis in ST-segment-elevation myocardial infarction (STEMI) without cardiac arrest and cardiogenic shock in the United States [1]. They bring up an important point that acute aortic dissection may mimic STEMI, and therefore, the receipt of fibrinolysis may be associated with catastrophic complications in this sub-group. The emphasis on this manuscript was to highlight that despite being a less-preferred strategy as compared to primary percutaneous coronary intervention (PCI), the outcomes of fibrinolysis followed by PCI in th...
Source: International Journal of Cardiology - Category: Cardiology Authors: Tags: Letter to the Editor Source Type: research
Conclusion: AF may be related with worse outcomes in patients undergoing MC implantation, including long-term mortality, major bleeding, and rehospitalization. AF should be taken into account when referring a patient for MC treatment.
Source: Medicine - Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research
In patients with refractory heart failure, there is increasing interest in the use of temporary mechanical circulatory support devices as a bridge to recovery or advanced cardiac therapies. One such family of devices, Impella (ABIOMED), is approved for use in acute myocardial infarction complicated by cardiogenic shock (AMI-CS), but has seen increased use in non-AMI-CS. The goal of this study was to better characterize patient selection for device implantation and outcomes among a contemporary cohort of patients supported with Impella for cardiogenic shock.
Source: Journal of Cardiac Failure - Category: Cardiology Authors: Tags: 451 Source Type: research
Recent innovations have led to the use of percutaneous ventricular assist devices (pVADs) in patients presenting with ST- elevation myocardial infarction (STEMI) complicated by cardiogenic shocks (CS). The purpose of this study was to look at recent trends and predictors of utilization of pVADS in patients with STEMI-CS
Source: Journal of Cardiac Failure - Category: Cardiology Authors: Tags: 448 Source Type: research
Right ventricular failure (RVF) is associated with increased mortality among patients receiving left ventricular mechanical circulatory support (LV-MCS) for cardiogenic shock and requires prompt recognition and management. Increased central venous pressure (CVP) is an indicator of potential RVF. We analyzed the association between hemodynamic parameters and clinical outcomes among 132 patients with cardiogenic shock due to acute myocardial infarction in the cVAD registry who had a CVP measured during left-sided Impella support.
Source: Journal of Cardiac Failure - Category: Cardiology Authors: Tags: 151 Source Type: research
[Short version of the 2nd edition of the German-Austrian S3 guidelines "Cardiogenic shock complicating myocardial infarction-Diagnosis, monitoring and treatment"]. Anaesthesist. 2020 Sep 30;: Authors: Werdan K, Boeken U, Briegel MJ, Buerke M, Geppert A, Janssens U, Kelm M, Michels G, Pilarczyk K, Schlitt A, Thiele H, Willems S, Zeymer U, Zwißler B, Delle-Karth G, Ferrari M, Figulla H, Heller A, Hindricks G, Pichler-Cetin E, Pieske BM, Prondzinsky R, Thielmann M, Bauersachs J, Kopp I, Ruß M Abstract BACKGROUND: The present guidelines ( http://leitlinien.net ) focus exclusively on ...
Source: Der Anaesthesist - Category: Anesthesiology Authors: Tags: Anaesthesist Source Type: research
Conclusion LMWH could reduce the risk of major bleeding in patients receiving IABP. Whether LMWH could reduce arterial thromboembolism needs further investigation. [...] Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals: Table of contents  |  Abstract  |  open access Full text
Source: The Thoracic and Cardiovascular Surgeon - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Original Cardiovascular Source Type: research
TUESDAY, Sept. 29, 2020 -- Among young adults with acute myocardial infarction-cardiogenic shock (AMI-CS), women are treated less aggressively and have higher in-hospital mortality than men, according to a study published online Sept. 29 in...
Source: Drugs.com - Pharma News - Category: Pharmaceuticals Source Type: news
We report our early postoperative outcomes of repair versus replacement.MethodsData were collected for patients undergoing first ‐time mitral valve surgery for severe IMR between 1990 and 2009 (n = 393). Patients who underwent combined procedures for papillary muscle rupture, post‐infarction ventricular septal defect, endocarditis, or any previous cardiac surgery were excluded. Preoperative demographics, operative variables, and hospital outcomes were analyzed, and multivariable regre ssion analysis was employed to identify independent predictors of hospital mortality.ResultsValve repair was performed in ...
Source: Journal of Cardiac Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: ORIGINAL ARTICLE Source Type: research
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