Clinical Significance of Residual Ischemia in Acute Myocardial Infarction Complicated by Cardiogenic Shock Undergoing VA-ECMO

• Published in: European heart journal. Acute cardiovascular care 2024-05
• Main Authors: Hong, David, Choi, Ki Hong, Ahn, Chul-Min, Yu, Cheol Woong, Park, Ik Hyun, Jang, Woo Jin, Kim, Hyun-Joong, Bae, Jang-Whan, Kwon, Sung Uk, Lee, Hyun-Jong, Lee, Wang Soo, Jeong, Jin-Ok, Park, Sang-Don, Park, Taek Kyu, Lee, Joo Myung, Song, Young Bin, Hahn, Joo-Yong, Choi, Seung-Hyuk, Gwon, Hyeon-Cheol, Yang, Jeong Hoon
• Format: Article
• Language: English
• ISSN: 2048-8734

Although culprit-only revascularization during the index procedure has been recommended in patients with acute myocardial infarction (AMI) complicated by cardiogenic shock (CS), the reduction of residual ischemia is also emphasized to improve clinical outcomes. However, few data are available about the significance of residual ischemia in patients undergoing mechanical circulatory supports. This study aimed to evaluate the effects of residual ischemia on clinical outcomes in AMI patients undergoing venoarterial-extracorporeal membrane oxygenation (VA-ECMO). AMI patients with multivessel disease who underwent VA-ECMO due to refractory CS were pooled from the RESCUE and SMC-ECMO registries. The included patients were classified into three groups according to residual ischemia evaluated using the residual SYNTAX score (rSS): rSS = 0, 0  8. The primary outcome was 1-year all-cause death. A total of 408 patients were classified into the rSS = 0 (N = 100, 24.5%), 0  8 (N = 172, 42.2%) groups. The cumulative incidence of the primary outcome differed significantly according to rSS (33.9% vs. 55.4% vs. 66.1% for rSS = 0, 0  8, respectively, overall P