Association of Left Ventricular Size on Outcomes in Patients With Left Main Coronary Artery Myocardial Infarction Complicated by Cardiogenic Shock.

IF 2.2 3区医学 Q3 ENGINEERING, BIOMEDICAL

Artificial organs Pub Date : 2025-02-26 DOI:10.1111/aor.14974

Naoki Tadokoro, Satoshi Kainuma, Kimito Minami, Satsuki Fukushima

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引用次数: 0

Abstract

Background: Cardiogenic shock in left main coronary artery acute myocardial infarction patients has high mortality rates. This study investigates the association between left ventricular size and outcomes in these patients treated with veno-arterial extracorporeal membrane oxygenation.

Methods: This retrospective single-center study examined patients who underwent percutaneous coronary intervention for left main coronary artery acute myocardial infarction and developed refractory cardiogenic shock between April 2013 and August 2021. Baseline characteristics and echocardiographic assessments were conducted 24-48 h after veno-arterial extracorporeal membrane oxygenation initiation. Patients were divided into two groups: small left ventricle (S-group, ≤ 23 mm/m² for males and ≤ 26 mm/m² for females, n = 11) and regular left ventricle (R-group, n = 22). The primary outcome was a 1-year survival. The analysis included survival and adjusted multivariate Cox proportional hazards modeling.

Results: The S-group showed a significantly higher mortality rate during support (63.6% vs. 4.5%, p = 0.001). In the unadjusted survival analysis, the 1-year survival rate was significantly lower in the S-group (9.0% [95% CI, 1.4-58.9] vs. 59.1% [95% CI, 41.7-83.6], p < 0.01). After adjusting for confounders, multivariate Cox analysis identified a small left ventricle (adjusted HR 8.38, 95% CI 2.33-30.16, p = 0.001), advanced age (per 10-year increase, adjusted HR 2.35, 95% CI 1.39-3.98, p = 0.001), and lower baseline left ventricular ejection fraction (per 10% decrease, adjusted HR 0.48, 95% CI 0.26-0.88, p = 0.018) as significant predictors of 1-year all-cause mortality.

Conclusions: In patients with severe cardiogenic shock following left main coronary artery acute myocardial infarction requiring veno-arterial extracorporeal membrane oxygenation, a small left ventricle is associated with a poor prognosis.

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来源期刊

Artificial organs 工程技术-工程：生物医学

CiteScore

4.30

自引率

12.50%

发文量

303

审稿时长

4-8 weeks

期刊介绍： Artificial Organs is the official peer reviewed journal of The International Federation for Artificial Organs (Members of the Federation are: The American Society for Artificial Internal Organs, The European Society for Artificial Organs, and The Japanese Society for Artificial Organs), The International Faculty for Artificial Organs, the International Society for Rotary Blood Pumps, The International Society for Pediatric Mechanical Cardiopulmonary Support, and the Vienna International Workshop on Functional Electrical Stimulation. Artificial Organs publishes original research articles dealing with developments in artificial organs applications and treatment modalities and their clinical applications worldwide. Membership in the Societies listed above is not a prerequisite for publication. Articles are published without charge to the author except for color figures and excess page charges as noted.