| Early extracorporeal membrane oxygenator-assisted primary percutaneous coronary intervention improved 30-day clinical outcomes in patients with ST-segment elevation myocardial infarction complicated with profound cardiogenic shock. | |
| | |
MedLine Citation:
|
PMID: 20543669 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVES: This study tested the hypothesis that early extracorporeal membrane oxygenator offered additional benefits in improving 30-day outcomes in patients with acute ST-segment elevation myocardial infarction complicated with profound cardiogenic shock undergoing primary percutaneous coronary intervention. METHODS: Between May 1993 and July 2002, 920 patients with acute ST-segment elevation myocardial infarction underwent primary percutaneous coronary intervention. Of these patients, 12.5% (115) with cardiogenic shock were enrolled in this study (group 1). Between August 2002 and December 2009, 1650 patients with acute ST-segment elevation myocardial infarction underwent primary percutaneous coronary intervention. Of these patients, 13.3% (219) complicated with cardiogenic shock were enrolled (group 2). RESULTS: The incidence of profound shock (defined as systolic blood pressure remaining < or =75 mm Hg after intra-aortic balloon pump and inotropic agent supports) was similar in both groups (21.7% vs. 21.0%, p > .5). Extracorporeal membrane oxygenator support, which was available only for patients in group 2, was performed in the catheterization room. The results demonstrated that final thrombolysis in myocardial infarction grade 3 flow in infarct-related artery was similar between the two groups (p = .678). However, total 30-day mortality and the mortality of patients with profound shock were lower in group 2 than in group 1 (all p < .04). Additionally, the hospital survival time was remarkably longer in patients in group 2 than in patients in group 1 (p = .0005). Furthermore, multivariate analysis demonstrated that unsuccessful reperfusion, presence of advanced congestive heart failure, profound shock, and age were independent predictors of 30-day mortality (all p < .02). CONCLUSION: Early extracorporeal membrane oxygenator-assisted primary percutaneous coronary intervention improved 30-day outcomes in patients with ST-segment elevation myocardial infarction with complicated with profound cardiogenic shock. |
| | |
Authors:
|
Jiunn-Jye Sheu; Tzu-Hsien Tsai; Fan-Yen Lee; Hsiu-Yu Fang; Cheuk-Kwan Sun; Steve Leu; Cheng-Hsu Yang; Shyh-Ming Chen; Chi-Ling Hang; Yuan-Kai Hsieh; Chien-Jen Chen; Chiung-Jen Wu; Hon-Kan Yip |
Related Documents
:
|
791649 - Heart failure in experimental refractory shock. 10525249 - Induction of ventricular fibrillation by t wave shocks: observations from monophasic ac... 19092649 - Cardiovascular manifestations of sedatives and analgesics in the critical care unit. 20571889 - Sepsis-induced cardiomyopathy: a review of pathophysiologic mechanisms. 16484889 - Analysis of the outcome for patients experiencing myocardial infarction and cardiopulmo... 8059489 - Biological effects of shock waves: induction of arrhythmia in piglet hearts. 20185659 - Cardiac output monitoring using indicator-dilution techniques: basics, limits, and pers... 7826309 - Myocardial perfusion measured by dual-isotope acquisition of 81rubidium/81mkrypton: an ... 15819299 - Antecedent hypertension interacts with adverse ventricular remodeling after myocardial ... |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: Critical care medicine Volume: 38 ISSN: 1530-0293 ISO Abbreviation: Crit. Care Med. Publication Date: 2010 Sep |
Date Detail:
|
Created Date: 2010-08-20 Completed Date: 2010-09-27 Revised Date: 2011-02-09 |
Medline Journal Info:
|
Nlm Unique ID: 0355501 Medline TA: Crit Care Med Country: United States |
Other Details:
|
Languages: eng Pagination: 1810-7 Citation Subset: AIM; IM |
Affiliation:
|
Division of Cardiovascular Surgery, Department of Surgery, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan, Republic of China. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aged Angioplasty, Balloon, Coronary* Electrocardiography Extracorporeal Membrane Oxygenation* Female Humans Male Middle Aged Myocardial Infarction / complications, surgery* Shock, Cardiogenic / complications* Treatment Outcome |
| Comments/Corrections | |
Comment In:
|
Crit Care Med. 2011 Feb;39(2):422; author reply 422-3
[PMID:
21248538
]
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Blunt chest trauma induces mediator-dependent monocyte migration to the lung.
Next Document: Role of regulatory T cells in long-term immune dysfunction associated with severe sepsis.