ECLS in Cardiogenic Shock: New Trial Reveals No Survival Advantage, Highlights Safety Concerns

Germany: Extracorporeal life support (ECLS), a treatment increasingly employed for infarct-related cardiogenic shock, has raised questions about its impact on mortality due to the lack of evidence. A recent multicenter trial published in the New England Journal Of Medicine by Holger Thiele and colleagues aimed to address this uncertainty by investigating the effects of early ECLS in patients with acute myocardial infarction complicated by cardiogenic shock.
The study suggested that for patients with acute myocardial infarction complicated by cardiogenic shock and early planned revascularization, the addition of ECLS therapy did not result in a lower risk of all-cause mortality at the 30-day follow-up compared to those receiving medical therapy alone.
The trial involved 420 patients who were randomly assigned to receive either early ECLS in addition to usual medical treatment (ECLS group) or usual medical treatment alone (control group). The primary outcome measured was all-cause mortality at 30 days. Safety outcomes, including bleeding, stroke, and peripheral vascular complications requiring intervention or surgery, were also assessed.
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