• Fabio Rigamonti, Fabrizio Montecucco, Filippo Boroli, Florian Rey, Baris Gencer, Mustafa Cikirikcioglu, Stéphane Reverdin, Federico Carbone, Stephane Noble, Marco Roffi, Carlo Banfi, and Raphael Giraud.
• Division of Cardiology, Department of Medical Specialties, Geneva University Hospitals, 4 rue Gabrielle-Perret-Gentil, 1205 Geneva, Switzerland. Electronic address: Fabio.rigamonti@hcuge.ch.
• Int. J. Cardiol. 2016 Oct 15; 221: 741-5.

BackgroundParameters allowing for outcome discrimination of extracorporeal membrane oxygenation (ECMO) therapy in acute coronary syndromes (ACS) complicated by refractory cardiogenic shock (CS) and/or cardio-respiratory arrest (CA) remain elusive. We aimed at evaluating the potential prognostic roles of blood and procedural parameters associated with 30-day mortality following ECMO.Methods And ResultsA group of 29 patients with ACS complicated by CS and/or CA, who underwent ECMO at a single center, was retrospectively analyzed. Eighteen patients (62%) died at 30-day follow up. "Survivors" and "non-survivors" had similar demographics, clinical and biochemical characteristics at admission, except for blood lactate peak in the first 24h that was increased in non-survivors. Procedural characteristics of percutaneous coronary intervention (PCI) and ECMO were comparable in either group. The peak of blood lactate concentration predicted 30-day mortality independently of age, sex and ECMO duration. The cutoff value, determined by receiver operating characteristic (ROC) curve analysis, was found at 11mmol/l.ConclusionsThe peak of serum lactate under ECMO in the first 24h predicted 30-day mortality in patients with ACS complicated with CS and CA.Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

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