Effect of different methods of hemodynamic support for patients with cardiac shock complicating acute myocardial infarctionduring percutaneous coronary intervention process
10.3969/j.issn.1006-5725.2024.23.006
- VernacularTitle:急性心肌梗死合并心源性休克患者不同器械辅助支持下急诊经皮介入治疗效果
- Author:
Minghua LUO
1
;
Yushan CHEN
1
;
He WANG
1
;
Huaimin GUAN
1
;
Jinhong XIE
1
Author Information
1. 河南中医药大学第一附属医院心脏中心,国家中医心血管病临床医学研究中心河南中医药大学第一附属医院分中心(河南郑州 450000)
- Publication Type:Journal Article
- Keywords:
acute myocardial infarction;
cardiogenic shock;
extracorporeal membrane oxygenation;
intra-aortic balloon pump;
primary percutaneous coronary intervention;
mechanical circulatory support
- From:
The Journal of Practical Medicine
2024;40(23):3317-3322
- CountryChina
- Language:Chinese
-
Abstract:
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 myocar-dial 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 differ-ences 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 com-bined 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 rela-tively higher mechanical complications.
