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Predictors of Mortality in Patients Treated with Veno-Arterial ECMO for Cardiogenic Shock Complicating Acute Myocardial Infarction: a Systematic Review and Meta-Analysis.
- Source :
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Journal of cardiovascular translational research [J Cardiovasc Transl Res] 2022 Apr; Vol. 15 (2), pp. 227-238. Date of Electronic Publication: 2021 Jun 03. - Publication Year :
- 2022
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Abstract
- Background: Mortality for patients on veno-arterial extracorporeal membrane oxygenation (VA-ECMO) for cardiogenic shock (CS) complicating acute myocardial infarction (AMI) remains high. This meta-analysis aims to identify factors that predict higher risk of mortality after VA-ECMO for AMI.<br />Methods: We meta-analyzed mortality after VA-ECMO for CS complicating AMI and the effect of factors from systematically selected studies published after 2009.<br />Results: 72 studies (10,276 patients) were included with a pooled mortality estimate of 58 %. With high confidence in estimates, failure to achieve TIMI III flow and left main culprit were identified as factors associated with higher mortality. With low-moderate confidence, older age, high BMI, renal dysfunction, increasing lactate, prothrombin activity < 50%, VA-ECMO implantation after revascularization, and non-shockable ventricular arrythmias were identified as factors associated with mortality.<br />Conclusion: These results provide clinicians with a framework for selecting patients for VA-ECMO for CS complicating AMI.<br /> (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Details
- Language :
- English
- ISSN :
- 1937-5395
- Volume :
- 15
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Journal of cardiovascular translational research
- Publication Type :
- Academic Journal
- Accession number :
- 34081255
- Full Text :
- https://doi.org/10.1007/s12265-021-10140-w