Trial reportEuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology2023
Venoarterial extracorporeal membrane oxygenation or standard care in patients with cardiogenic shock complicating acute myocardial infarction: the multicentre, randomised EURO SHOCK trial.
Trial report in EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06645990 (Early Left Ventricular unLoading by Impella), which is not on this map. Cited by 69 papers, 6 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Early Left Ventricular unLoading by Impella (ECMELLA) or Intra-aortic Balloon Pump for Cardiogenic Shock in Patients on VA-ECMO
Who cites it
69 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- European Resuscitation Council and European Society of Intensive Care Medicine guidelines 2025: post-resuscitation care.Intensive care medicine · 2025Guideline
- Impact of left ventricular unloading timing on clinical outcomes in venoarterial extracorporeal membrane oxygenation: an updated systematic review and meta-analysis.BMC cardiovascular disorders · 2025Pooled it
- IMPELLA COMPARED TO VENOARTERIAL EXTRACORPOREAL MEMBRANE OXYGENATION IN CARDIOGENIC SHOCK: A SYSTEMATIC REVIEW AND META-ANALYSIS OF PROPENSITY SCORE-MATCHED STUDIES.Shock (Augusta, Ga.) · 2025Pooled it
- Outcome and complications in postcardiotomy cardiogenic shock treated with extracorporeal life support - a systematic review and meta-analysis.BMC anesthesiology · 2025Pooled it
- Efficacy and safety of extracorporeal membrane oxygenation for cardiogenic shock complicating myocardial infarction: a systematic review and meta-analysis.BMC cardiovascular disorders · 2024Pooled it
- Mechanical circulatory support for cardiogenic shock: a network meta-analysis of randomized controlled trials and propensity score-matched studies.Intensive care medicine · 2024Pooled it
- Cardiac index, SvOCritical care (London, England) · 2025Trial
- Evolving Evidence-Driven Strategies in Cardiogenic Shock Management.JACC. Advances · 2026Review
- Baseline Ventricular-Arterial Coupling Modifies Left Atrial Pressure Response to Venoarterial Extracorporeal Membrane Oxygenation In Vitro.Artificial organs · 2026Article
- Left ventricular unloading during VA-ECMO for refractory cardiogenic shock: a target trial emulation multicenter analysis.Critical care (London, England) · 2026Article
- Veno-arterial ECMO in fulminant myocarditis: a retrospective single-center case series.BMC cardiovascular disorders · 2026Article
- Novel treatment strategies in cardiogenic shock: an update on ongoing clinical trials.Heart failure reviews · 2026Review
- Hemi-ECMO: A Novel Method of Left Ventricular Afterload Reduction for Venoarterial Extracorporeal Membrane Oxygenation (VA-ECMO).Bioengineering (Basel, Switzerland) · 2026Article
- Mechanical circulatory support in cardiogenic shock: a contemporary head-to-head comparison.Heart failure reviews · 2026Review
- Venoarterial extracorporeal membrane oxygenation (VA-ECMO) in high-risk (HR) percutaneous coronary intervention (PCI).Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2026Article
- Short-Term Percutaneous Mechanical Circulatory Support in Acute Coronary Syndrome with Cardiogenic Shock: Which Device to Choose?Journal of cardiovascular development and disease · 2026Review
- Venoarterial extracorporeal membrane oxygenation in adults with cardiogenic shock.Frontiers in cardiovascular medicine · 2026Review
- Frailty and outcomes after extracorporeal membrane oxygenation: a binational registry-based cohort study.Critical care (London, England) · 2025Article
- Cardiogenic Shock Management in the Modern Era: A Narrative Review of Percutaneous Mechanical Circulatory Support Devices.Journal of cardiovascular development and disease · 2025Review
- Extracorporeal Membrane Oxygenation in Acute Cardiovascular Care.Circulation reports · 2025Review
9 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
22 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCardiogenic shock (CGS) occurs in 10% of patients presenting with acute myocardial infarction (MI), with in-hospital mortality rates of 40-50% despite revascularisation.
aimsThe EURO SHOCK trial aimed to determine if early use of venoarterial extracorporeal membrane oxygenation (VA-ECMO) could improve outcomes in patients with persistent CGS following primary percutaneous coronary intervention (PPCI).
methodsThis multicentre, pan-European trial randomised patients with persistent CGS 30 minutes after PPCI of the culprit lesion to receive either VA-ECMO or continue with standard therapy. The primary outcome measure was 30-day all-cause mortality in an intention-to-treat analysis. Secondary endpoints included 12-month all-cause mortality and 12-month composite of all-cause mortality or rehospitalisation due to heart failure.
resultsDue to the impact of the COVID-19 pandemic, the trial was stopped before completion of recruitment, after randomisation of 35 patients (standard therapy n=18, VA-ECMO n=17). Thirty-day all-cause mortality occurred in 43.8% of patients randomised to VA-ECMO and in 61.1% of patients randomised to standard therapy (hazard ratio [HR] 0.56, 95% confidence interval [CI]: 0.21-1.45; p=0.22). One-year all-cause mortality was 51.8% in the VA-ECMO group and 81.5% in the standard therapy arm (HR 0.52, 95% CI: 0.21-1.26; p=0.14). Vascular and bleeding complications occurred more often in the VA-ECMO arm (21.4% vs 0% and 35.7% vs 5.6%, respectively).
conclusionsDue to the limited number of patients recruited to the trial, no definite conclusions could be drawn from the available data. Our study demonstrates the feasibility of randomising patients with CGS complicating acute MI but also illustrates the challenges. We hope these data will inspire and inform the design of future large-scale trials.
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