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Paddock, Sophie, Meng, James, Johnson, Nicholas, Chattopadhyay, Rahul, Tsampasian, Vasiliki and Vassiliou, Vassilios 
ORCID: https://orcid.org/0000-0002-4005-7752
(2024)
The impact of extracorporeal membrane oxygenation on mortality in patients with cardiogenic shock post-acute myocardial infarction:a systematic review and meta-analysis.
European Heart Journal Open, 4 (1).
ISSN 2752-4191
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Abstract
Aims Cardiogenic shock remains the leading cause of death in patients hospitalized with acute myocardial infarction. Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is increasingly used in the treatment of infarct-related cardiogenic shock. However, there is limited evidence regarding its beneficial impact on mortality. The aim of this study was to systematically review studies reporting the impact of VA-ECMO on mortality in patients with acute myocardial infarction complicated by cardiogenic shock. Methods and results A comprehensive search of medical databases (Cochrane Register and PubMed) was conducted. Studies that reported mortality outcomes in patients treated with VA-ECMO for infarct-related cardiogenic shock were included. The database search yielded 1194 results, of which 11 studies were included in the systematic review. Four of these studies, with a total of 586 patients, were randomized controlled trials and were included in the meta-analysis. This demonstrated that there was no significant difference in 30-day all-cause mortality with the use of VA-ECMO compared with standard medical therapy [odds ratio (OR) 0.91; 95% confidence interval (CI) 0.65–1.27]. Meta-analysis of two studies showed that VA-ECMO was associated with a significant reduction in 12-month all-cause mortality (OR 0.31; 95% CI 0.11–0.86). Qualitative synthesis of the observational studies showed that age, serum creatinine, serum lactate, and successful revascularization are independent predictors of mortality. Conclusion Veno-arterial extracorporeal membrane oxygenation does not improve 30-day all-cause mortality in patients with cardiogenic shock following acute myocardial infarction; however, there may be significant reduction in all-cause mortality at 12 months. Further studies are needed to delineate the potential benefit of VA-ECMO in long-term outcomes.
| Item Type: | Article |
|---|---|
| Additional Information: | Funding Information: S.P. and J.M. are National Institute for Health and Care Research (NIHR) funded Academic Clinical Fellows. R.C. is funded by a Wellcome Trust PhD Fellowship. V.T. is funded by an NIHR Doctoral Research Fellowship. Publisher Copyright: © The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology. |
| Uncontrolled Keywords: | acute myocardial infarction,cardiogenic shock,extracorporeal membrane oxygenation,cardiology and cardiovascular medicine,surgery ,/dk/atira/pure/subjectarea/asjc/2700/2705 |
| Faculty \ School: | Faculty of Medicine and Health Sciences > Norwich Medical School |
| UEA Research Groups: | Faculty of Science > Research Groups > Norwich Epidemiology Centre Faculty of Medicine and Health Sciences > Research Groups > Norwich Epidemiology Centre Faculty of Medicine and Health Sciences > Research Groups > Cardiovascular and Metabolic Health Faculty of Medicine and Health Sciences > Research Centres > Metabolic Health |
| Related URLs: | |
| Depositing User: | LivePure Connector |
| Date Deposited: | 28 May 2024 09:31 |
| Last Modified: | 28 May 2024 09:31 |
| URI: | https://ueaeprints.uea.ac.uk/id/eprint/95313 |
| DOI: | 10.1093/ehjopen/oeae003 |
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