Veno-arterial extracorporeal membrane oxygenation for cardiogenic shock after acute myocardial infarction: Insights from a French nationwide database.
Veno-arterial extracorporeal membrane oxygenation for cardiogenic shock after acute myocardial infarction: Insights from a French nationwide database.
复制标题
急性心肌梗死后心源性休克的静脉-动脉体外膜氧合：来自法国全国数据库的见解。
DOI：
10.1016/j.ijcard.2023.03.037
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发表时间：
2023
影响因子：
3.5
通讯作者：
Antoine Dueclos
中科院分区：
文献类型：
--
作者：
M. Pozzi;C. Payet;S. Polazzi;Aubane L'Hospital;J. Obadia;Antoine Dueclos
背景我们的目的是分析植入时机的影响（战略-成果关系）和程序量（容量-结果关系）对急性心肌梗死（AMI）并发心源性休克患者行静脉-动脉体外膜肺氧合（VA ECMO）治疗的存活率的影响。使用2013年1月至2019年12月期间的全国数据库进行分析。我们将患者分为早期植入（直接经皮冠状动脉介入治疗[PCI]当天的VA ECMO）和延迟植入（PCI当天之后的VA ECMO）组。我们将患者分为低或高容量组的基础上，中位数hospitalvolume.ResultsDuring研究期间，649 VA ECMO植入20家法国医院。平均年龄为57.1 ± 10.4岁，80%为男性。总体而言，90天死亡率为64.3%。早期植入组患者（n= 479，73.8%）的90天死亡率与延迟植入组患者（n= 170，26.2%）相比无统计学差异（HR：1.18; 95% CI 0.94-1.48;p= 0.153）。在研究期间，低容量中心的VA ECMO平均植入数量为21.3 ± 5.4，而高容量中心为43.6 ± 11.8。高容量和低容量中心之间的90天死亡率无显著差异（HR：1.00; 95%CI：0.82-1.23;p= 0.995）。ConclusionsIn this real world national study，we did not find a significant association between early VA ECMO implantation as well as the high-volume centers and lower mortality in AMI-related refractory cardiogenic shock.
BackgroundWe aimed to analyze the impact of timing of implantation (strategy-outcome relationship) and volume of procedures (volume-outcome relationship) on survival of veno-arterial extracorporeal membrane oxygenation (VA ECMO) for cardiogenic shock complicating acute myocardial infarction (AMI).MethodsWe conducted an observational retrospective study through two propensity score-based analyses using a nationwide database between January 2013 and December 2019. We classified patients into early implantation (VA ECMO on the day of primary percutaneous coronary intervention [PCI]) and delayed implantation (VA ECMO beyond the day of PCI) groups. We classified patients into low- or high-volume groups based on the median hospital volume.ResultsDuring the study period 649 VA ECMO were implanted across 20 French hospitals. Mean age was 57.1 ± 10.4 years, 80% were male. Overall, 90-day mortality was 64.3%. Patients in the early implantation group (n= 479, 73.8%) did not show a statistical difference in 90-day mortality than in the delayed group (n= 170, 26.2%) (HR: 1.18; 95% CI 0.94–1.48;p= 0.153). The mean number of VA ECMO implanted during the study period by low-volume centers was 21.3 ± 5.4 as compared to 43.6 ± 11.8 in high-volume centers. There was no significant difference in 90-day mortality between high-volume and low-volume centers (HR: 1.00; 95% CI: 0.82–1.23;p= 0.995).ConclusionsIn this real-world nationwide study, we did not find a significant association between early VA ECMO implantation as well as high-volume centers and lower mortality in AMI-related refractory cardiogenic shock.
影响因子：
120.7
作者：
Samsky, Marc D.;Morrow, David A.;Proudfoot, Alastair G.;Hochman, Judith S.;Thiele, Holger;Rao, Sunil V.
通讯作者：
Rao, Sunil V.
影响因子：
9.7
作者：
Vallabhajosyula, Saraschandra;Prasad, Abhiram;Barsness, Gregory W.
通讯作者：
Barsness, Gregory W.