Antithrombin III at admission as a new predictive factors for mortality in ECMO for cardiogenic shock caused by acute myocardial infarction.

Extracorporeal membrane oxygenation (ECMO) is a technique increasingly used in the practice of intensive therapy for extracorporeal gas exchange and/or circulatory support in patients with acute respiratory and/or cardiac failure, when conventional treatment modalities are ineffective. We aimed to investigate the association of antithrombin III with clinical outcomes in patients with cardiogenic shock caused by acute myocardial infarction undergoing ECMO. We retrospectively studied patients with acute myocardial infarction complicated by cardiogenic shock undergoing ECMO in four hospitals in China. The in-hospital mortality rate was 47.8% (194/406). The antithrombin III at admission of the in-hospital death group (n = 194) and the survival group (n = 212) were 45.70 ± 21.57 and 50.97 ± 25.37%, respectively. In-hospital mortality and acute kidney injury, and serum creatinine in the antithrombin III at admission < 46% group were significantly higher than that in the antithrombin III at admission ≥ 46% group. By univariate and multivariate analysis, serum albumin < 30 g/L, low AT III at admission, and serum lactate were found to be related to in-hospital mortality. Our investigation demonstrated that low antithrombin III at admission was associated with in-hospital in cardiogenic shock secondary to acute myocardial infarction on ECMO, suggesting that antithrombin III may be an indicator of shock severity.