VA-ECMO With IABP is Associated With Better Outcome Than VA-ECMO Alone in the Treatment of Cardiogenic Shock in ST-Elevation Myocardial Infarction
Key result
In STEMI complicated by cardiogenic shock, VA-ECMO combined with IABP was associated with higher survival compared to VA-ECMO alone (100% vs 55%; P=.04).
Why the study?
VA-ECMO increases afterload in the treatment of cardiogenic shock, and combining it with IABP has been suggested to reduce afterload and improve survival in STEMI.
Does combining VA-ECMO with IABP improve survival and neurological outcomes in patients with STEMI complicated by cardiogenic shock compared to VA-ECMO alone?
Population
18 STEMI patients with cardiogenic shock
Comparison
VA-ECMO + IABP vs VA-ECMO alone
Design
Multicenter in-hospital registry
Authors
Discussion
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Member takes
Implication
May support combined support in STEMI shock; leaves open randomized confirmation before practice change.
Study Design
Type
Cohort (n=18)
Multicenter
Yes
Structured PICO
Does combining VA-ECMO with IABP improve survival and neurological outcomes in patients with STEMI complicated by cardiogenic shock compared to VA-ECMO alone?
P
Population
18 patients (median age 59, 22% female) with STEMI complicated by cardiogenic shock treated with VA-ECMO with or without IABP.
E
Exposure
Venoarterial extracorporeal membrane oxygenation (VA-ECMO) combined with intra-aortic balloon pump (IABP)
C
Comparator
VA-ECMO alone
O
Outcome
Survival and good neurological outcomehard clinical
Main Result
Absolute Event Rate: 100% vs 55%
p-value: p=.04
In patients with STEMI complicated by cardiogenic shock, combining VA-ECMO with IABP was associated with significantly higher survival and better neurological outcomes compared to VA-ECMO alone, despite more complex coronary anatomy.
Cite This Study
Brink et al. (2021) conducted a cohort in Cardiogenic shock in ST-elevation myocardial infarction (n=18). VA-ECMO + IABP vs. VA-ECMO alone was evaluated on Survival (p=.04). In STEMI complicated by cardiogenic shock, VA-ECMO combined with IABP was associated with higher survival compared to VA-ECMO alone (100% vs 55%; P=.04).