Key result
In patients with fulminant myocarditis, veno-arterial extracorporeal membrane oxygenation use was associated with a higher risk of death, durable LVAD, or heart transplant (HR 5.27; 95% CI 1.60-17.36).
Why the study?
Prognoses and long-term cardiac function of patients with fulminant myocarditis have not been fully elucidated across different mechanical circulatory support requirements and histological findings.
Does veno-arterial extracorporeal membrane oxygenation compared to intra-aortic balloon pump or Impella alone worsen the composite of death, durable left ventricular assist device implantation, and heart transplantation in patients with fulminant myocarditis requiring percutaneous mechanical circulatory support?
Population
216 patients with fulminant myocarditis requiring percutaneous mechanical circulatory support
Comparison
Types of percutaneous mechanical circulatory support and histological subtypes
Design
Multicenter retrospective medical record review
Follow-up
Up to 6 years
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Caution advised interpreting VA-ECMO in fulminant myocarditis; leaves open selection bias versus causal effect.
Observational (n=216)
Yes
Does veno-arterial extracorporeal membrane oxygenation compared to intra-aortic balloon pump or Impella alone worsen the composite of death, durable left ventricular assist device implantation, and heart transplantation in patients with fulminant myocarditis requiring percutaneous mechanical circulatory support?
Hazard Ratio: 5.27 (95% CI 1.6–17.36)
In patients with fulminant myocarditis requiring mechanical circulatory support, the need for VA-ECMO is associated with a significantly worse prognosis compared to IABP or Impella alone.
A 2022 study conducted an observational in Fulminant myocarditis (n=216). Veno-arterial extracorporeal membrane oxygenation vs. Intra-aortic balloon pump or Impella alone was evaluated on Composite of death, durable left ventricular assist device implantation, and heart transplantation (HR 5.27, 95% CI 1.60-17.36). In patients with fulminant myocarditis, veno-arterial extracorporeal membrane oxygenation use was associated with a higher risk of death, durable LVAD, or heart transplant (HR 5.27; 95% CI 1.60-17.36).
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