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Comparison of in-hospital outcomes of patients with vs. without ischaemic cardiomyopathy undergoing veno-arterial-extracorporeal membrane oxygenation
- Title
- Comparison of in-hospital outcomes of patients with vs. without ischaemic cardiomyopathy undergoing veno-arterial-extracorporeal membrane oxygenation
- Authors
- Seong S.-W.; Jin G.; Kim M.; Ahn K.T.; Yang J.H.; Gwon H.-C.; Ko Y.-G.; Yu C.W.; Chun W.J.; Jang W.J.; Kim H.-J.; Bae J.-W.; Kwon S.U.; Lee H.-J.; Lee W.S.; Park S.-D.; Cho S.S.; Ahn J.H.; Song P.S.; Jeong J.-O.
- Ewha Authors
- 장우진
- SCOPUS Author ID
- 장우진
- Issue Date
- 2021
- Journal Title
- ESC Heart Failure
- ISSN
- 2055-5822
- Citation
- ESC Heart Failure vol. 8, no. 4, pp. 3308 - 3315
- Keywords
- Cardiogenic shock; ECMO; Ischaemic cardiomyopathy; Non-ischaemic cardiomyopathy
- Publisher
- John Wiley and Sons Inc
- Indexed
- SCIE; SCOPUS
- Document Type
- Article
- Abstract
- Aims: This study aimed to investigate differences in baseline and treatment characteristics, and in-hospital mortality according to the aetiologies of cardiogenic shock in patients undergoing veno-arterial-extracorporeal membrane oxygenation (VA-ECMO). Methods and results: The RESCUE registry is a multicentre, observational cohort that includes 1247 patients with cardiogenic shock from 12 centres. A total of 496 patients requiring VA-ECMO were finally selected, and the study population was stratified by cardiogenic shock aetiology [ischaemic cardiomyopathy (ICM, n = 342) and non-ICM (NICM, n = 154)]. The primary outcome of interest was in-hospital mortality. Sensitivity analyses including propensity-score matching adjustments were performed. Mean age of the entire population was 61.8 ± 14.2, and 30.8% were women. There were significant differences in baseline characteristics; notable differences included the older age of patients with ICM (65.1 ± 13.7 vs. 58.2 ± 13.8, P < 0.001), preponderance of males [258 (75.4%) vs. 85 (55.2%), P < 0.001], and higher prevalence of diabetes mellitus [140 (40.9%) vs. 39 (25.3%), P = 0.001] compared with patients in the NICM aetiology group. Patients with ischaemic cardiogenic shock were more likely to have longer shock duration before VA-ECMO implantation (518.7 ± 941.4 min vs. 292.4 ± 707.8 min, P = 0.003) and were less likely to undergo distal limb perfusion than those with NICM [108 (31.6%) vs. 79 (51.3%), P < 0.001]. In-hospital mortality in the overall cohort was 52.2%; patients with ICM had a higher unadjusted risk of in-hospital mortality [203 (59.4%) vs. 56 (36.4%); unadjusted hazard ratio, 2.295; 95% confidence interval, 1.698–3.100; P < 0.001]. There were no significant differences in the primary outcome between the two aetiologies following propensity-score matching multiple adjustments (adjusted hazard ratio, 1.265; 95% confidence interval, 0.840–1.906; P = 0.260). Conclusions: Results of the current study indicated among patients with cardiogenic shock undergoing VA-ECMO, ischaemic aetiology does not seem to impact in-hospital mortality. These findings underline that early initiation and appropriate treatment strategies of VA-ECMO for patients with ICM shock are required. © 2021 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.
- DOI
- 10.1002/ehf2.13481
- Appears in Collections:
- 의료원 > 의료원 > Journal papers
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