Different mechanical circulatory support strategies for infarct-related cardiogenic shock: a subanalysis of the ECLS-SHOCK Trial
Background - Mechanical circulatory support (MCS) devices are frequently used in patients with acute myocardial infarction complicated by cardiogenic shock. In clinical practice, escalation of MCS device therapy is performed in a significant proportion of patients aiming to improve hemodynamic statu...
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| Hauptverfasser: | , , , , , , , , , , , , , , , , , , , , |
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| Dokumenttyp: | Article (Journal) |
| Sprache: | Englisch |
| Veröffentlicht: |
24 March 2025
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| In: |
JACC Cardiovascular interventions
Year: 2025, Jahrgang: 18, Heft: 6, Pages: 691-701 |
| ISSN: | 1876-7605 |
| DOI: | 10.1016/j.jcin.2024.12.010 |
| Online-Zugang: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.jcin.2024.12.010 Verlag, lizenzpflichtig, Volltext: https://www.sciencedirect.com/science/article/pii/S1936879824018600 
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| Verfasserangaben: | Hans-Josef Feistritzer, MD, PHD, Uwe Zeymer, MD, Taoufik Ouarrak, MSC, Ibrahim Akin, MD, Tienush Rassaf, MD, Ralf Lehmann, MD, Ingo Eitel, MD, Tim Seidler, MD, Carsten Skurk, MD, Peter Clemmensen, MD, Ingo Voigt, MD, Melchior Seyfarth, MD, Axel Linke, MD, Eike Tigges, MD, Christian Jung, MD, Philipp Lauten, MD, Janine Pöss, MD, Steffen Schneider, PHD, Steffen Desch, MD, Anne Freund, MD, Holger Thiele, MD, the ECLS-SHOCK Investigators |
MARC
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| 245 | 1 | 0 | |a Different mechanical circulatory support strategies for infarct-related cardiogenic shock |b a subanalysis of the ECLS-SHOCK Trial |c Hans-Josef Feistritzer, MD, PHD, Uwe Zeymer, MD, Taoufik Ouarrak, MSC, Ibrahim Akin, MD, Tienush Rassaf, MD, Ralf Lehmann, MD, Ingo Eitel, MD, Tim Seidler, MD, Carsten Skurk, MD, Peter Clemmensen, MD, Ingo Voigt, MD, Melchior Seyfarth, MD, Axel Linke, MD, Eike Tigges, MD, Christian Jung, MD, Philipp Lauten, MD, Janine Pöss, MD, Steffen Schneider, PHD, Steffen Desch, MD, Anne Freund, MD, Holger Thiele, MD, the ECLS-SHOCK Investigators |
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| 500 | |a Online verfügbar: 24. März 2025, Artikelversion: 24. März 2025 | ||
| 500 | |a Gesehen am 21.07.2025 | ||
| 520 | |a Background - Mechanical circulatory support (MCS) devices are frequently used in patients with acute myocardial infarction complicated by cardiogenic shock. In clinical practice, escalation of MCS device therapy is performed in a significant proportion of patients aiming to improve hemodynamic status. - Objectives - The aim of this study was to analyze outcomes of different MCS device strategies in the ECLS-SHOCK (Extracorporeal Life Support in Cardiogenic Shock) trial. - Methods - The present subanalysis from the ECLS-SHOCK trial analyzed outcomes of patients treated with upfront extracorporeal life support (ECLS) only, bailout MCS, and escalated MCS therapy. The primary outcome was 30-day all-cause mortality. - Results - Upfront ECLS only, bailout MCS, and escalated MCS therapy were used in 165 (78.9%), 54 (26.0%), and 27 (12.9%) patients, respectively. Thirty-day all-cause mortality was 44.8% (95% CI: 37.1%-52.8%), 61.1% (95% CI: 46.9%-74.1%), and 55.6% (95% CI: 35.3%-74.5%) in the upfront ECLS, bailout MCS, and escalated MCS group (P = 0.09). Need for renal replacement therapy was higher in the bailout MCS (35.2%; 95% CI: 22.7%-49.4%) than in upfront ECLS (7.3%; 95% CI: 3.8%-12.4%) and escalated MCS (14.8%; 95% CI: 4.2%-33.8%) (P < 0.001). Moderate or severe bleeding complications were similar in the upfront ECLS (25.5%; 95% CI: 19.0%-32.8%), bailout MCS (22.2%; 95% CI: 12.0%-35.6%), and escalated MCS (22.2%; 95% CI: 8.6%-42.3%) group (P = 0.86). - Conclusions - Bailout and escalated MCS therapy is associated with numerically higher 30-day mortality compared with upfront ECLS use only. Bailout MCS use is also associated with higher need for renal replacement therapy. (Extracorporeal Life Support in Cardiogenic Shock [ECLS-SHOCK]; NCT03637205) | ||
| 650 | 4 | |a cardiogenic shock | |
| 650 | 4 | |a extracorporeal life support | |
| 650 | 4 | |a mechanical circulatory support | |
| 650 | 4 | |a myocardial infarction | |
| 650 | 4 | |a venoarterial extracorporeal membrane oxygenation | |
| 700 | 1 | |a Zeymer, Uwe |e VerfasserIn |4 aut | |
| 700 | 1 | |a Ouarrak, Taoufik |e VerfasserIn |4 aut | |
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| 700 | 1 | |a Lehmann, Ralf |e VerfasserIn |4 aut | |
| 700 | 1 | |a Eitel, Ingo |e VerfasserIn |4 aut | |
| 700 | 1 | |a Seidler, Tim |e VerfasserIn |4 aut | |
| 700 | 1 | |a Skurk, Carsten |e VerfasserIn |4 aut | |
| 700 | 1 | |a Clemmensen, Peter |e VerfasserIn |4 aut | |
| 700 | 1 | |a Voigt, Ingo |e VerfasserIn |4 aut | |
| 700 | 1 | |a Seyfarth, Melchior |e VerfasserIn |4 aut | |
| 700 | 1 | |a Linke, Axel |e VerfasserIn |4 aut | |
| 700 | 1 | |a Tigges, Eike |e VerfasserIn |4 aut | |
| 700 | 1 | |a Jung, Christian |e VerfasserIn |4 aut | |
| 700 | 1 | |a Lauten, Philipp |e VerfasserIn |4 aut | |
| 700 | 1 | |a Pöss, Janine |e VerfasserIn |4 aut | |
| 700 | 1 | |a Schneider, Steffen |e VerfasserIn |4 aut | |
| 700 | 1 | |a Desch, Steffen |e VerfasserIn |4 aut | |
| 700 | 1 | |a Freund, Anne |e VerfasserIn |4 aut | |
| 700 | 1 | |a Thiele, Holger |e VerfasserIn |4 aut | |
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