Cardiology in critical care · Mechanical support in cardiogenic shock
Extracorporeal Life Support in Infarct-Related Cardiogenic Shock
| Design | Multicentre randomised controlled trial |
|---|---|
| Treatment | Extracorporeal life support plus usual care |
| Control | Usual care alone |
| Population | 417 analysed patients with acute myocardial infarction complicated by cardiogenic shock and planned early revascularisation |
| Follow-up | 30 days |
| Primary endpoint | Death from any cause at 30 days |
| Result | Death from any cause at 30 days occurred in 100 of 209 (47.8%) with extracorporeal life support and 102 of 208 (49.0%) with usual care. |
| Secondary endpoints | Bleeding, peripheral ischaemic complications, renal replacement therapy |
In patients with acute myocardial infarction complicated by cardiogenic shock with planned early revascularization, the risk of death from any cause at the 30-day follow-up was not lower among the patients who received ECLS.
The trial authors, in the published abstract
The largest ECMO trial in cardiogenic shock, and clearly negative — with more bleeding and vascular complications for the trouble. Together with ECMO-CS it makes routine ECMO in this setting hard to justify, which sharpens the contrast with DanGer Shock.
Thiele H, Zeymer U, Akin I, et al. Extracorporeal Life Support in Infarct-Related Cardiogenic Shock. N Engl J Med 2023 Oct 5;389(14):1286-1297.