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Effect of different methods of hemodynamic support for patients with cardiac shock complicating acute myocardial infarctionduring percutaneous coronary intervention process
Received date: 2024-04-07
Online published: 2024-12-16
Objective To evaluate the effect of extracorporeal membrane oxygenation combined with intra-aortic balloon pump mechanical circulatory support for patients with cardiogenic shock complicating acute myocardial infarction during PCI process. Methods Patients with cardiogenic shock complicating myocardial infarction who underwent PCI in the hospital from January 2015 to December 2019 were selected. Those who were under support of extracorporeal membrane oxygenation combined with intra-aortic balloon pump were enrolled in the observation group， the patients under support of only intra-aortic balloon pump were selectedin the control group. The differences of clinical features and prognosis were compared. Results A total of 40 patients were enrolled， 11 were in the observation group and 29 in the control group. Compared with control group， more patients were complicated with old myocardial infarction （5/11 vs. 2/29， P = 0.016）， more patients were diagnosed as non-ST elevated myocardial infarction （8/11 vs. 11/29， P = 0.049） and left ventricular ejecting fraction was lower ［（38.5 ± 10.10） vs. （48.55 ± 8.86）， P = 0.01］ in observation group. Moreover， the proportion of patients with EF < 35% was higher in the observation group （5/11 vs. 3/29， P = 0.01）. The observation group has significantly higher rates of multi-vessel disease and Syntax scores compared to the control group （multi-vessel disease： 10/11 vs. 11/29， P = 0.02； Syntax score： ［（33.36 ± 13.37） vs. （25.74 ± 5.75）， P = 0.015］； the observation group exhibited a higher proportion of patients achieving complete revascularization（9/11 vs. 8/29，P = 0.002）. Mechanical complications were higher in observation group（6/11 vs. 5/29， P = 0.02）， The survive rate in observation group is higher than that in control group（91.00% vs.55.17%， P = 0.03）at one-year follow-up. Conclusion Compared with only IABP， ECMO combined with IABP hemodynamic support during PCI process for patients with cardiogenic shock complicating acute myocardial infarction enjoys more complete revascularization and better mortality outcome， although it has relatively higher mechanical complications.
Minghua LUO , Yushan CHEN , He WANG , Huaimin GUAN , Jinhong. XIE . Effect of different methods of hemodynamic support for patients with cardiac shock complicating acute myocardial infarctionduring percutaneous coronary intervention process[J]. The Journal of Practical Medicine, 2024 , 40(23) : 3317 -3322 . DOI: 10.3969/j.issn.1006-5725.2024.23.006
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