Organ support & nutrition

Microaxial Flow Pump or Standard Care in Infarct-Related Cardiogenic Shock

N Engl J MedPublished Randomised controlled trial

Primary result · Death from any causeResult — go to the resultHazard ratio 0.74 95% CI 0.55–0.99

Authors' conclusion

The routine use of a microaxial flow pump with standard care in the treatment of patients with STEMI-related cardiogenic shock led to a lower risk of death from any cause at 180 days than standard care alone. The incidence of a composite of adverse events was higher with the use of the microaxial flow pump.

Study context

Population
Patients with STEMI and cardiogenic shock355 analysed
Participants
360 patients
Comparison
Microaxial flow pump plus standard care vs standard care alone
  • Microaxial flow pumpn = 179
  • Standard caren = 176reference
Primary endpoint
Death from any cause
Follow-up
180 days
Methodological detailsinternational, multicentre
  • International
  • Multicentre

Primary result

As reported in the abstract

Hazard ratio

0.74

95% CI 0.55–0.99

P = 0.04

Events by treatment group

Microaxial flow pump vs Standard care
HR 0.74 (95% CI 0.55–0.99); P = 0.04

Safety

OutcomeMicroaxial flow pumpStandard careRR (95% CI)
Composite safety end point (severe bleeding, limb ischemia, hemolysis, device failure or worsening aortic regurgitation)24.0%6.2%4.74 (2.36–9.55)
Renal-replacement therapy41.9%26.7%1.98 (1.27–3.09)

Original publication

Microaxial Flow Pump or Standard Care in Infarct-Related Cardiogenic Shock. N Engl J Med. Published 7 April 2024. doi:10.1056/nejmoa2312572

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