Prognosis of refractory cardiogenic shock in de-novo versus acute-on-chronic heart failure: Insights from the HYPO-ECMO trial
Authors' conclusion
In VA-ECMO-treated CS, ACHF was associated with comparable 30-day survival but lower 180-day mortality and morbidity-mortality.
Study context
- Population
- Patients with refractory cardiogenic shock (CS) treated with VA-ECMO in the HYPO-ECMO trialwith HF history information
- Participants
- 321 patients
- Comparison
- Acute-on-chronic HF vs de-novo HF
- Acute-on-chronic heart failure (ACHF)n = 65
- Primary endpoint
- All-cause mortality
- Follow-up
- Day 30
Methodological detailspost-hoc, exploratory, inverse probability weighting
- Post-hoc
- Exploratory
- Inverse probability weighting
Primary result
As reported in the abstract
ACHF vs DNHFCrude risk difference (CI)P value
ACHF
−7.7 %(−21.0 to 5.7)
P = 0.26- Inverse probability weighting
- Inverse probability weighting (IPW) risk difference (RD) −11.6 % (CI −24.8 to 1.6); P = 0.084
Secondary outcomes
Effect of moderate hypothermia (33-34 °C) on primary outcome (de-novo HF (DNHF) subgroup) · day 30
| RD (CI) | P value | ||
|---|---|---|---|
| MHDNHF group | −10.9 % (−23.1 to 1.2) | P = 0.078 | |
| −30−20−10010Difference (linear scale) |
| Outcome | IPW RD (CI) | P value |
|---|---|---|
| Mortality · up to day 180 | −13.7 % (−27.1 to −0.2) | P = 0.047 |
| Composite of death, heart transplant, escalation to LV assist device, or stroke · up to day 180 | −19.5 % (−32.9 to −6.1) | P = 0.004 |
- Effect of moderate hypothermia (33-34 °C) on primary outcome (DNHF subgroup): no significant interaction (p > 0.05)
Effect of moderate hypothermia (33-34 °C) on primary outcome (DNHF subgroup) · day 30
- Significant reduction in composite outcome with moderate hypothermia (MH) in DNHF but not in ACHF (p < 0.05 at each timepoint)
Original publication
Prognosis of refractory cardiogenic shock in de-novo versus acute-on-chronic heart failure: Insights from the HYPO-ECMO trial. J Crit Care. Published 28 February 2025. doi:10.
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