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Predictors of Survival and Ventricular Recovery Following Acute Myocardial Infarction Requiring Extracorporeal Membrane Oxygenation Therapy.
Fried, Justin A; Griffin, Jan M; Masoumi, Amirali; Clerkin, Kevin J; Witer, Lucas J; Topkara, Veli K; Karmpaliotis, Dimitri; Rabbani, LeRoy; Colombo, Paolo C; Yuzefpolskaya, Melana; Takayama, Hiroo; Naka, Yoshifumi; Kirtane, Ajay J; Brodie, Daniel; Sayer, Gabriel; Uriel, Nir; Takeda, Koji; Garan, A Reshad.
Afiliación
  • Fried JA; From the Department of Medicine, Division of Cardiology, Columbia University Medical Center, New York, New York.
  • Griffin JM; From the Department of Medicine, Division of Cardiology, Columbia University Medical Center, New York, New York.
  • Masoumi A; From the Department of Medicine, Division of Cardiology, Columbia University Medical Center, New York, New York.
  • Clerkin KJ; From the Department of Medicine, Division of Cardiology, Columbia University Medical Center, New York, New York.
  • Witer LJ; Department of Surgery, Division of Cardiothoracic Surgery, Medical University of South Carolina, Charleston, South Carolina.
  • Topkara VK; From the Department of Medicine, Division of Cardiology, Columbia University Medical Center, New York, New York.
  • Karmpaliotis D; From the Department of Medicine, Division of Cardiology, Columbia University Medical Center, New York, New York.
  • Rabbani L; From the Department of Medicine, Division of Cardiology, Columbia University Medical Center, New York, New York.
  • Colombo PC; From the Department of Medicine, Division of Cardiology, Columbia University Medical Center, New York, New York.
  • Yuzefpolskaya M; From the Department of Medicine, Division of Cardiology, Columbia University Medical Center, New York, New York.
  • Takayama H; Department of Surgery, Division of Cardiothoracic Surgery, Columbia University Medical Center, New York, New York.
  • Naka Y; Department of Surgery, Division of Cardiothoracic Surgery, Columbia University Medical Center, New York, New York.
  • Kirtane AJ; From the Department of Medicine, Division of Cardiology, Columbia University Medical Center, New York, New York.
  • Brodie D; Department of Medicine, Division of Pulmonary/Critical Care, Columbia University Medical Center, New York, New York.
  • Sayer G; From the Department of Medicine, Division of Cardiology, Columbia University Medical Center, New York, New York.
  • Uriel N; From the Department of Medicine, Division of Cardiology, Columbia University Medical Center, New York, New York.
  • Takeda K; Department of Surgery, Division of Cardiothoracic Surgery, Columbia University Medical Center, New York, New York.
  • Garan AR; Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
ASAIO J ; 68(6): 800-807, 2022 06 01.
Article en En | MEDLINE | ID: mdl-35380184
The use of venoarterial extracorporeal membrane oxygenation (VA-ECMO) following acute myocardial infarction with cardiogenic shock (AMI-CS) is increasing, but the ability to predict favorable outcomes with support remains limited. We retrospectively reviewed all patients with AMI-CS supported with VA-ECMO between December 2008 and June 2018. One hundred twenty-six patients received VA-ECMO for AMI-CS during the study period; of these, 39 (31.0%) experienced ventricular recovery and were discharged while 87 (69.0%) did not recover, with 71 (56.3%) dying in the hospital and 16 (12.7%) surviving to discharge with either left ventricular assist device or heart transplant. TIMI 3 flow in culprit artery (OR, 4.01; 95% CI, 1.25-12.77; p = 0.02), serum lactate (OR, 0.89; 95% CI, 0.80-0.99; p = 0.04), and prompt revascularization (OR, 3.39; 95% CI, 1.18-9.81; p = 0.02) were independent predictors of ventricular recovery. Four variables emerged as independent predictors of in-hospital mortality and were used to create the AMI-ECMO Risk Score: age >70 years, creatinine >1.5 mg/dL, serum lactate > 4.0 mmol/L, and lack of TIMI 3 flow in culprit artery. In patients supported with VA-ECMO for AMI-CS, prompt, successful revascularization, and lower serum lactate were associated with ventricular recovery while younger age, lower serum lactate, and creatinine, and successful revascularization were associated with survival to discharge. The AMI-ECMO risk score is a simple tool that can help risk stratify patients with AMI-CS being considered for VA-ECMO support.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Oxigenación por Membrana Extracorpórea / Infarto del Miocardio Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Humans Idioma: En Revista: ASAIO J Asunto de la revista: TRANSPLANTE Año: 2022 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Oxigenación por Membrana Extracorpórea / Infarto del Miocardio Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Humans Idioma: En Revista: ASAIO J Asunto de la revista: TRANSPLANTE Año: 2022 Tipo del documento: Article Pais de publicación: Estados Unidos