PMID- 33893793
OWN - NLM
STAT- MEDLINE
DCOM- 20210917
LR  - 20210917
IS  - 1557-2501 (Electronic)
IS  - 1042-3931 (Linking)
VI  - 33
IP  - 5
DP  - 2021 May
TI  - VA-ECMO With IABP is Associated With Better Outcome Than VA-ECMO Alone in the 
      Treatment of Cardiogenic Shock in ST-Elevation Myocardial Infarction.
PG  - E387-E392
LID - JIC20210420-1 [pii]
AB  - OBJECTIVE: To assess whether combining venoarterial extracorporeal membrane 
      oxygenation (VA-ECMO) with intra-aortic balloon pump (IABP) improves outcomes in 
      ST-segment elevation myocardial infarction (STEMI) over VA-ECMO alone. 
      BACKGROUND: VA-ECMO is an upcoming technique in the treatment of cardiogenic 
      shock (CS); however, it increases afterload. IABP + VA-ECMO has been suggested to 
      reduce afterload and increase survival. METHODS: A multicenter in-hospital 
      registry was maintained on all patients undergoing VA-ECMO or VA-ECMO + IABP 
      treatment for CS in STEMI. RESULTS: Between 2015 and 2018, a total of 18 patients 
      with STEMI underwent VA-ECMO +/- IABP treatment for CS. The majority (n = 14; 78%) 
      were male and median age was 59 years (interquartile range, 47-75 years). VA-ECMO 
      + IABP was performed in 7 patients (39%) and VA-ECMO alone was performed in 11 
      patients (61%). The VA-ECMO + IABP group had more complex coronary anatomy and a 
      higher number of patients with left main (LM) disease, LM + 3-vessel disease, or 
      3-vessel disease (VA-ECMO + IABP 86% vs VA-ECMO alone 18%; P=.03). The Survival 
      After Veno-Arterial Extracorporeal Membrane Oxygenation (SAVE) score did not 
      differ between the groups (VA-ECMO alone -5.9 +/- 2.4 vs VA-ECMO + IABP -6.1 +/- 2.6; 
      P=.88). The SYNTAX score was higher in the VA-ECMO + IABP group (32 +/- 13 vs 22 +/- 
      14 in the VA-ECMO alone group). In the total group, a SAVE score of -6 had a 
      predicted survival of 25%-35%. Survival in the VA-ECMO + IABP group was 100% 
      (7/7) and survival in the VA-ECMO group was 55% (6/11); P=.04. Good neurological 
      outcome was achieved in more patients in the VA-ECMO + IABP group (VA-ECMO alone 
      45% vs VA-ECMO + IABP 100%; P=.04). CONCLUSION: In STEMI complicated by CS, 
      VA-ECMO + IABP leads to a lower observed mortality and higher observed good 
      neurological outcome.
FAU - van den Brink, Floris S
AU  - van den Brink FS
AD  - Koopvaardersplantsoen 83, 1034KE, Amsterdam, The Netherlands. 
      floris.s.van.den.brink@gmail.com.
FAU - Zivelonghi, Carlo
AU  - Zivelonghi C
FAU - Vossenberg, Tessel N
AU  - Vossenberg TN
FAU - Bleeker, Gabe B
AU  - Bleeker GB
FAU - Winia, Vivian L
AU  - Winia VL
FAU - Sjauw, Krischan D
AU  - Sjauw KD
FAU - Ten Berg, Jurrien M
AU  - Ten Berg JM
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20210420
PL  - United States
TA  - J Invasive Cardiol
JT  - The Journal of invasive cardiology
JID - 8917477
SB  - IM
MH  - *Extracorporeal Membrane Oxygenation
MH  - Female
MH  - *Heart-Assist Devices
MH  - Humans
MH  - Intra-Aortic Balloon Pumping
MH  - Male
MH  - Middle Aged
MH  - *ST Elevation Myocardial Infarction/complications/diagnosis/surgery
MH  - Shock, Cardiogenic/diagnosis/etiology/therapy
MH  - Treatment Outcome
OTO - NOTNLM
OT  - IABP
OT  - VA-ECMO
OT  - intra-aortic balloon pump
OT  - primary PCI
OT  - venoarterial extracorporeal membrane oxygenation
EDAT- 2021/04/25 06:00
MHDA- 2021/09/18 06:00
CRDT- 2021/04/24 12:04
PHST- 2021/04/25 06:00 [pubmed]
PHST- 2021/09/18 06:00 [medline]
PHST- 2021/04/24 12:04 [entrez]
AID - JIC20210420-1 [pii]
PST - ppublish
SO  - J Invasive Cardiol. 2021 May;33(5):E387-E392. Epub 2021 Apr 20.