Study on the prognostic factors related to interventional therapy in patients with acute myocardial infarction assisted by VA-ECMO
10.3760/cma.j.cn112148-20250428-00318
- VernacularTitle:VA-ECMO辅助下急性心肌梗死患者介入治疗预后相关因素研究
- Author:
Junduo WU
1
;
Chunpeng ZHANG
1
;
Bo LI
1
;
Lei ZHAO
1
;
Jinwu LI
1
;
Mingsong ZHANG
1
;
Shengnan XU
1
;
Bin LIU
1
Author Information
1. 吉林大学第二医院心血管内科，长春 130041
- Publication Type:Journal Article
- Keywords:
Myocardial infarction;
Percutaneous coronary intervention;
Extracorporeal membrane oxygenation
- From:
Chinese Journal of Cardiology
2025;53(6):661-665
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the prognostic factors in patients with acute myocardial infarction (AMI) who underwent interventional therapy assisted by venous-arterial extracorporeal membrane oxygenation (VA-ECMO).Methods:This single-center retrospective cohort study enrolled AMI patients who received VA-ECMO-assisted interventional therapy in the Department of Cardiology at the Second Hospital of Jilin University from June 2018 to November 2022. Patients were divided into the in-hospital survival group and in-hospital death group based on the in-hospital survival. Data on patient demographics, laboratory tests, imaging examinations, coronary angiography results, VA-ECMO-related parameters, complications, and prognosis were collected through the electronic medical record system.Results:A total of 71 AMI patients were enrolled, with an age of (62.4±11.1) years, of whom 54 (76%) were male. There were 46 patients in the in-hospital survival group and 25 patients in the in-hospital death group. Compared to the in-hospital survival group, the in-hospital death group exhibited significantly higher levels of cardiac troponin I (36.08 (2.86, 100.00) μg/L vs. 2.75 (0.18, 13.86) μg/L, P=0.01) and B-type natriuretic peptide (1 724.50 (50.00, 4 200.50) vs. 460.85 (163.80, 1 862.33), P=0.01), and the left ventricular ejection fraction was lower ((35.0±12.9)% vs. (43.0±12.8)%, P=0.01), moreover the incidence of patients with left main coronary artery disease (80% (20/25) vs. 39% (18/46), P<0.01), cardiac arrest (56% (14/25) vs. 20% (9/46), P<0.01), cardiopulmonary resuscitation (52%(13/25) vs. 26%(12/46), P=0.03), and the time from cardiac arrest to ECMO initiation >24 hours (84% (21/25) vs. 9% (4/46), P<0.01) were higher. Conclusions:The prognosis of AMI patients undergoing VA-ECMO-assisted interventional therapy may be influenced by a number of related factors, including cardiac troponin I, B-type natriuretic peptide levels, left ventricular ejection fraction, combined with left main coronary artery disease, cardiac arrest and cardiopulmonary resuscitation, and the interval between cardiac arrest and the initiation of ECMO.
