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Updated: Aug 24, 2025
Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
Published on: June 12, 2021
[Mechanical circulatory support in refractory cardiogenic shock: retrospective register study]
P P Savvinova1,2, V N Manchurov1,2, B L Haes2
1Yevdokimov Moscow State University of Medicine and Dentistry.
Insights
Mechanical circulatory support (MCS) significantly reduces mortality in acute myocardial infarction (AMI) patients with cardiogenic shock (CS). VA-ECMO showed particular effectiveness, suggesting its consideration for improved outcomes in these critical cases.
Area of Science:
- Cardiology
- Critical Care Medicine
- Medical Devices
Context:
- Cardiogenic shock (CS) is a major cause of mortality in acute myocardial infarction (AMI).
- Despite advancements, mortality rates for CS remain high.
- Mechanical circulatory support (MCS) offers a promising therapeutic avenue.
Purpose:
- To evaluate the effectiveness and safety of MCS in patients diagnosed with AMI and CS.
- To compare outcomes between patients receiving MCS and those not receiving it.
Summary:
- A study of 47 patients with AMI and refractory CS revealed significantly lower mortality in those treated with MCS (59%) compared to those without (93%).
- Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) demonstrated a significant impact on reducing mortality (p=0.02), whereas intra-aortic balloon pump (IABP) did not show statistical significance (p=0.16).
Impact:
- VA-ECMO is associated with reduced mortality in AMI patients experiencing refractory CS.
- Findings suggest VA-ECMO should be strongly considered for managing refractory CS in AMI.
- Further research is warranted to determine the optimal MCS strategy for CS patients.
Abstract:
Cardiogenic shock (CS) is one of the main causes of death in patients with acute myocardial infarction (AMI). Mortality from CS remains high, despite the introduction of myocardial revascularization and the use of modern medication. The use of mechanical circulatory support (MCS) is promising, it could reduce mortality in patients with AMI and CS.
Aim:
To define effectiveness and safety of MCS in patients with AMI and CS.
Materials And Methods:
Our study includes 47 patients with AMI and refractory CS, who were treated at the University Clinic of Cardiology of the Yevdokimov Moscow State University of Medicine and Dentistry from 2019 to 2022. Mortality and various complications were analyzed in patients with refractory CS, patients who received and did not receive mechanical circulatory support (intra-aortic balloon pump IABP, extracorporeal membrane oxygenation ECMO).
Results:
Mortality among patients with refractory CS was significantly lower in the subgroup of patients who received mechanical circulatory support devices (59% vs 93%; p=0.02). Moreover, reliability is achieved mainly due to patients in whom were VA-ECMO implanted (p=0.02), not IABP (p=0.16).
Conclusion:
VA-ECMO associated with reduced mortality and should be considered in patients with AMI and refractory CS. Further research is needed to select the optimal method of mechanical circulatory support in patients with CS.
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