PMID- 35377180
OWN - NLM
STAT- MEDLINE
DCOM- 20220407
LR  - 20220716
IS  - 2047-9980 (Electronic)
IS  - 2047-9980 (Linking)
VI  - 11
IP  - 7
DP  - 2022 Apr 5
TI  - Outcomes of Venoarterial Extracorporeal Membrane Oxygenation Plus Intra-Aortic 
      Balloon Pumping for Treatment of Acute Myocardial Infarction Complicated by 
      Cardiogenic Shock.
PG  - e023713
LID - 10.1161/JAHA.121.023713 [doi]
LID - e023713
AB  - Background Clinical outcomes of acute myocardial infarction complicated by 
      cardiogenic shock remain poor with high in-hospital mortality. Veno-arterial 
      extracorporeal membrane oxygenation (VA-ECMO) has been widely used for patients 
      with acute myocardial infarction complicated by cardiogenic shock refractory to 
      conservative therapy, which is likely fatal without mechanical circulatory 
      support. However, whether additional intra-aortic balloon pumping (IABP) use 
      during VA-ECMO support improves clinical outcomes remains controversial. This 
      study sought to investigate prognostic impact of the combined VA-ECMO plus IABP 
      treatment compared with VA-ECMO alone. Methods and Results From the nationwide 
      Japanese administrative case-mix Diagnostic Procedure Combination (DPC), the 
      JROAD (Japanese Registry of All Cardiac and Vascular Diseases)-DPC, we identified 
      3815 patients with acute myocardial infarction complicated by cardiogenic shock 
      who underwent primary percutaneous coronary intervention and managed with 
      VA-ECMO. Of these, 2964 patients (77.7%) were managed with IABP (VA-ECMO plus 
      IABP), whereas 851 (22.3%) were managed without IABP (VA-ECMO alone). We compared 
      in-hospital, 7-day, and 30-day mortality between the VA-ECMO plus IABP versus the 
      VA-ECMO alone support. Patients managed with VA-ECMO plus IABP demonstrated 
      significantly lower in-hospital, 7-day, and 30-day mortality than those managed 
      with VA-ECMO alone (adjusted odds ratios [95% CI] of 0.47 [95% CI, 0.38-0.59], 
      0.41 [95% CI, 0.33-0.51], and 0.30 [95% CI, 0.25-0.37], respectively). The 
      findings were consistent in the propensity matching and inverse probability of 
      treatment-weighting models. Conclusions This large-scale, nationwide study 
      demonstrated that the combination of VA-ECMO plus IABP support was associated 
      with significantly lower mortality compared with VA-ECMO support alone in 
      patients presenting with acute myocardial infarction complicated by cardiogenic 
      shock who underwent primary percutaneous coronary intervention.
FAU - Nishi, Takeshi
AU  - Nishi T
AUID- ORCID: 0000-0002-5503-4692
AD  - Department of Cardiology Kawasaki Medical School Kurashiki Okayama Japan.
FAU - Ishii, Masanobu
AU  - Ishii M
AD  - Department of Cardiovascular Medicine Graduate School of Medical Sciences 
      Kumamoto University Kumamoto City Japan.
FAU - Tsujita, Kenichi
AU  - Tsujita K
AD  - Department of Cardiovascular Medicine Graduate School of Medical Sciences 
      Kumamoto University Kumamoto City Japan.
FAU - Okamoto, Hiroshi
AU  - Okamoto H
AD  - Department of Cardiology Kawasaki Medical School Kurashiki Okayama Japan.
FAU - Koto, Satoshi
AU  - Koto S
AD  - Department of Cardiology Kawasaki Medical School Kurashiki Okayama Japan.
FAU - Nakai, Michikazu
AU  - Nakai M
AUID- ORCID: 0000-0003-2240-1510
AD  - National Cerebral and Cardiovascular Center Suita Japan.
FAU - Sumita, Yoko
AU  - Sumita Y
AUID- ORCID: 0000-0002-1424-145X
AD  - National Cerebral and Cardiovascular Center Suita Japan.
FAU - Iwanaga, Yoshitaka
AU  - Iwanaga Y
AD  - National Cerebral and Cardiovascular Center Suita Japan.
FAU - Matoba, Satoaki
AU  - Matoba S
AD  - Department of Cardiovascular Medicine Graduate School of Medical Science Kyoto 
      Prefectural University of Medicine Kyoto Japan.
FAU - Kobayashi, Yoshio
AU  - Kobayashi Y
AD  - Department of Cardiovascular Medicine Chiba University Graduate School of 
      Medicine Chiba Japan.
FAU - Hirata, Ken-Ichi
AU  - Hirata KI
AD  - Division of Cardiovascular Medicine Department of Internal Medicine Kobe 
      University Graduate School of Medicine Kobe Japan.
FAU - Hikichi, Yutaka
AU  - Hikichi Y
AD  - Department of Cardiology Saga-Ken Medical Centre Koseikan Saga Japan.
FAU - Yokoi, Hiroyoshi
AU  - Yokoi H
AD  - Cardiovascular Center Fukuoka Sanno Hospital Fukuoka Japan.
FAU - Ikari, Yuji
AU  - Ikari Y
AUID- ORCID: 0000-0001-5686-4324
AD  - Department of Cardiovascular Medicine Tokai University School of Medicine Isehara 
      Japan.
FAU - Uemura, Shiro
AU  - Uemura S
AUID- ORCID: 0000-0002-6089-5358
AD  - Department of Cardiology Kawasaki Medical School Kurashiki Okayama Japan.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20220404
PL  - England
TA  - J Am Heart Assoc
JT  - Journal of the American Heart Association
JID - 101580524
SB  - IM
CIN - J Am Heart Assoc. 2022 Apr 5;11(7):e025274. PMID: 35377158
MH  - *Extracorporeal Membrane Oxygenation/adverse effects
MH  - Humans
MH  - Intra-Aortic Balloon Pumping/adverse effects
MH  - *Myocardial Infarction/complications/therapy
MH  - *Percutaneous Coronary Intervention/adverse effects
MH  - Shock, Cardiogenic/etiology/therapy
MH  - Treatment Outcome
PMC - PMC9075437
OTO - NOTNLM
OT  - acute myocardial infarction
OT  - cardiogenic shock
OT  - intra-aortic balloon pumping
OT  - venoarterial extracorporeal membrane oxygenation
EDAT- 2022/04/05 06:00
MHDA- 2022/04/08 06:00
PMCR- 2022/04/05
CRDT- 2022/04/04 12:14
PHST- 2022/04/05 06:00 [pubmed]
PHST- 2022/04/08 06:00 [medline]
PHST- 2022/04/04 12:14 [entrez]
PHST- 2022/04/05 00:00 [pmc-release]
AID - JAH37128 [pii]
AID - 10.1161/JAHA.121.023713 [doi]
PST - ppublish
SO  - J Am Heart Assoc. 2022 Apr 5;11(7):e023713. doi: 10.1161/JAHA.121.023713. Epub 
      2022 Apr 4.