High-Risk Factors of In-Hospital Death Following Complex High-risk and Indicated Patients After Percutaneous Coronary Intervention Supported by Extracorporeal Membrane Oxygenation
Background: Complex high-risk and indicated patients (CHIPs) increase the risk of in-hospital death after percutaneous coronary intervention (PCI). Extracorporeal membrane oxygenation (ECMO) support can improve survival. However, there remains a gap in knowledge regarding how to i...
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| Format: | Article |
| Language: | English |
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IMR Press
2025-05-01
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| Series: | Reviews in Cardiovascular Medicine |
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| Online Access: | https://www.imrpress.com/journal/RCM/26/5/10.31083/RCM27126 |
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| author | Wenjie Qiu Wanying Chen Yajun Qin Yifang Zhou Yuanshen Zhou |
| author_facet | Wenjie Qiu Wanying Chen Yajun Qin Yifang Zhou Yuanshen Zhou |
| author_sort | Wenjie Qiu |
| collection | DOAJ |
| description | Background: Complex high-risk and indicated patients (CHIPs) increase the risk of in-hospital death after percutaneous coronary intervention (PCI). Extracorporeal membrane oxygenation (ECMO) support can improve survival. However, there remains a gap in knowledge regarding how to identify and manage these high-risk patients effectively to reduce mortality. This study aimed to determine the independent high-risk factors associated with increased risk of in-hospital mortality among CHIPs after PCI with ECMO support. This research focused on providing clinicians with more accurate risk assessment tools for devising more effective treatment plans for these patients. Methods: The EMBASE, PubMed, Cochrane Library, Web Of Science, Chinese Biomedical Database, China National Knowledge Infrastructure, China Science and Technology Journal Database, and Wanfang databases were searched from their inception to October 1, 2024, to identify observational studies examining mortality risk amongst adult CHIPs (age ≥18 years). The primary outcome was in-hospital mortality. A meta-analysis used random-effects models to obtain summary odds ratios (ORs) with 95% confidence intervals (CIs). The Cochrane risk-of-bias tool assessed the quality of evidence. Results: Ten studies with 306 participants were included. In pooled analyses, cardiogenic shock (CS) or cardiac arrest (CA) to ECMO (mean difference (MD) : 34.61, 95% confidence interval (CI): 26.70 to 42.52; p < 0.00001), ECMO duration (MD : –19.93, 95% CI: –32.85 to –7.02; p = 0.002), type of infarction-associated coronary artery-left anterior descending (LAD; OR : 3.16, 95% CI: 1.83 to 5.47; p < 0.0001), body mass index (BMI; MD: 1.52, 95% CI: 1.06 to 1.97; p < 0.00001), lactate levels (MD: 3.15, 95% CI: 2.37 to 3.94; p < 0.00001), left ventricle ejection fraction (LVEF; MD: –4.09, 95% CI: –6.17 to –2.00; p = 0.0001), mean arterial pressure (MAP; MD: –24.92, 95% CI: –32.19 to –17.65; p < 0.00001), heart rate, male sex, left circumflex, and right coronary artery, were associated with in-hospital mortality. Conclusions: CHIPs with longer CS or CA to ECMO, shorter ECMO duration, LAD infarction, higher BMI, elevated lactate levels, and lower LVEF and MAP have an increased risk of in-hospital death. |
| format | Article |
| id | doaj-art-2e9684b94e5f4487ba37b548b8aaac82 |
| institution | OA Journals |
| issn | 1530-6550 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | IMR Press |
| record_format | Article |
| series | Reviews in Cardiovascular Medicine |
| spelling | doaj-art-2e9684b94e5f4487ba37b548b8aaac822025-08-20T02:03:25ZengIMR PressReviews in Cardiovascular Medicine1530-65502025-05-012652712610.31083/RCM27126S1530-6550(24)01723-XHigh-Risk Factors of In-Hospital Death Following Complex High-risk and Indicated Patients After Percutaneous Coronary Intervention Supported by Extracorporeal Membrane OxygenationWenjie Qiu0Wanying Chen1Yajun Qin2Yifang Zhou3Yuanshen Zhou4The Second Clinical College of Guangzhou University of Chinese Medicine, 510006 Guangzhou, Guangdong, ChinaThe Second Clinical College of Guangzhou University of Chinese Medicine, 510006 Guangzhou, Guangdong, ChinaThe Second Clinical College of Guangzhou University of Chinese Medicine, 510006 Guangzhou, Guangdong, ChinaThe Second Clinical College of Guangzhou University of Chinese Medicine, 510006 Guangzhou, Guangdong, ChinaThe Second Clinical College of Guangzhou University of Chinese Medicine, 510006 Guangzhou, Guangdong, ChinaBackground: Complex high-risk and indicated patients (CHIPs) increase the risk of in-hospital death after percutaneous coronary intervention (PCI). Extracorporeal membrane oxygenation (ECMO) support can improve survival. However, there remains a gap in knowledge regarding how to identify and manage these high-risk patients effectively to reduce mortality. This study aimed to determine the independent high-risk factors associated with increased risk of in-hospital mortality among CHIPs after PCI with ECMO support. This research focused on providing clinicians with more accurate risk assessment tools for devising more effective treatment plans for these patients. Methods: The EMBASE, PubMed, Cochrane Library, Web Of Science, Chinese Biomedical Database, China National Knowledge Infrastructure, China Science and Technology Journal Database, and Wanfang databases were searched from their inception to October 1, 2024, to identify observational studies examining mortality risk amongst adult CHIPs (age ≥18 years). The primary outcome was in-hospital mortality. A meta-analysis used random-effects models to obtain summary odds ratios (ORs) with 95% confidence intervals (CIs). The Cochrane risk-of-bias tool assessed the quality of evidence. Results: Ten studies with 306 participants were included. In pooled analyses, cardiogenic shock (CS) or cardiac arrest (CA) to ECMO (mean difference (MD) : 34.61, 95% confidence interval (CI): 26.70 to 42.52; p < 0.00001), ECMO duration (MD : –19.93, 95% CI: –32.85 to –7.02; p = 0.002), type of infarction-associated coronary artery-left anterior descending (LAD; OR : 3.16, 95% CI: 1.83 to 5.47; p < 0.0001), body mass index (BMI; MD: 1.52, 95% CI: 1.06 to 1.97; p < 0.00001), lactate levels (MD: 3.15, 95% CI: 2.37 to 3.94; p < 0.00001), left ventricle ejection fraction (LVEF; MD: –4.09, 95% CI: –6.17 to –2.00; p = 0.0001), mean arterial pressure (MAP; MD: –24.92, 95% CI: –32.19 to –17.65; p < 0.00001), heart rate, male sex, left circumflex, and right coronary artery, were associated with in-hospital mortality. Conclusions: CHIPs with longer CS or CA to ECMO, shorter ECMO duration, LAD infarction, higher BMI, elevated lactate levels, and lower LVEF and MAP have an increased risk of in-hospital death.https://www.imrpress.com/journal/RCM/26/5/10.31083/RCM27126complex high-risk and indicated patientspercutaneous coronary interventionextracorporeal membrane oxygenationrisk factors of in-hospital deathmeta-analysis |
| spellingShingle | Wenjie Qiu Wanying Chen Yajun Qin Yifang Zhou Yuanshen Zhou High-Risk Factors of In-Hospital Death Following Complex High-risk and Indicated Patients After Percutaneous Coronary Intervention Supported by Extracorporeal Membrane Oxygenation Reviews in Cardiovascular Medicine complex high-risk and indicated patients percutaneous coronary intervention extracorporeal membrane oxygenation risk factors of in-hospital death meta-analysis |
| title | High-Risk Factors of In-Hospital Death Following Complex High-risk and Indicated Patients After Percutaneous Coronary Intervention Supported by Extracorporeal Membrane Oxygenation |
| title_full | High-Risk Factors of In-Hospital Death Following Complex High-risk and Indicated Patients After Percutaneous Coronary Intervention Supported by Extracorporeal Membrane Oxygenation |
| title_fullStr | High-Risk Factors of In-Hospital Death Following Complex High-risk and Indicated Patients After Percutaneous Coronary Intervention Supported by Extracorporeal Membrane Oxygenation |
| title_full_unstemmed | High-Risk Factors of In-Hospital Death Following Complex High-risk and Indicated Patients After Percutaneous Coronary Intervention Supported by Extracorporeal Membrane Oxygenation |
| title_short | High-Risk Factors of In-Hospital Death Following Complex High-risk and Indicated Patients After Percutaneous Coronary Intervention Supported by Extracorporeal Membrane Oxygenation |
| title_sort | high risk factors of in hospital death following complex high risk and indicated patients after percutaneous coronary intervention supported by extracorporeal membrane oxygenation |
| topic | complex high-risk and indicated patients percutaneous coronary intervention extracorporeal membrane oxygenation risk factors of in-hospital death meta-analysis |
| url | https://www.imrpress.com/journal/RCM/26/5/10.31083/RCM27126 |
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