Chapters
1, 11, 14, 15
Comparator
Usual care alone
ECMO type
VA
Intervention
Early VA ECMO plus usual care
Limitations
Open-label; crossover to ECMO in the control arm; confined to infarct-related shock in revascularised patients.
N
417
Population
Acute myocardial infarction complicated by cardiogenic shock, planned early revascularisation
Primary endpoint
All-cause death at 30 days
Result
48% vs 49%; RR 0.98 (95% CI 0.80-1.19), p=0.81. Moderate/severe bleeding 23% vs 10%; limb ischaemia requiring intervention 11% vs 4%.
Verified
What it does NOT tell us
It says nothing about non-infarct cardiogenic shock, ECPR, rescue cannulation in refractory shock, or LV unloading strategies.
What it tells us
Routine early VA ECMO in infarct-related cardiogenic shock does not reduce 30-day mortality and roughly doubles major bleeding and limb ischaemia.
Year
2023