Hemodynamics, fluids & transfusion
Bleeding complications, coagulation disorders, and their management in acute myocardial infarction-related cardiogenic shock rescued by veno-arterial ECMO: A retrospective cohort study
Authors' conclusion
Bleeding complications and coagulation disorders were frequent and severe in patients on VA-ECMO after AMI, leading of antiplatelet therapy withdrawal in one third of patients.
Study context
- Population
- Post-AMI cardiogenic shock patients requiring VA-ECMO176 received VA-ECMO
- Participants
- 132 patients
- Outcome
- Severe bleeding (Bleeding Academic Research Consortium classification)
Methodological detailsobservational, multivariable Fine-Gray competing risk model
- Observational
- Multivariable Fine-Gray competing risk model
Main finding
As reported in the abstract
Severe bleeding
Severe bleeding occurred
39%
Observational data: associations, not effects.
Further findings
Mortality
- Patients who died
- 65 (49%)
Coagulation disorders
- Severe thrombocytopenia (< 50 G/L)
- 31%
- Hypofibrinogenemia
- 19%
Antithrombotic management
- Dual antiplatelet therapy (DAPT) stopped
- 32%
- Stent thrombosis rate
- 6%
- Anticoagulation stopped
- 39%
Risk factors for severe bleeding (multivariate competing risk model)
- Female sex, time on ECMO, troponin at admission and Impella® implantation independently associated with severe bleeding
- Fine-Gray models
Original publication
Bleeding complications, coagulation disorders, and their management in acute myocardial infarction-related cardiogenic shock rescued by veno-arterial ECMO: A retrospective cohort study. J Crit Care. Published 12 March 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →