Comparing revascularization strategies for heart attack patients with cardiogenic shock

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This study is a prospective, open-label, two-arm, randomized multicenter trial aimed at determining whether immediate multi-vessel percutaneous coronary intervention (PCI) leads to better clinical outcomes compared to treating only the culprit lesion in patients with acute myocardial infarction (AMI) complicated by cardiogenic shock who require veno-arterial extracorporeal membrane oxygenation (VA-ECMO). The trial addresses the critical decision-making process regarding revascularization strategies in patients with multi-vessel disease, as current guidelines suggest caution in performing non-infarct related artery revascularization. By comparing these two approaches, the study seeks to provide insights into improving myocardial perfusion and hemodynamic stability in this high-risk population.

Why it matters

Who can join: the full rules

Inclusion Criteria:

* Subject must be at least 19 years of age
* Patients presented with AMI (ST-segment elevation MI \[STEMI\] or non-ST-segment elevation MI \[NSTEMI\]) complicated by CS (SCAI Shock classification C, D or E) who requiring VA-ECMO.
* Target lesions amenable for planned primary PCI by operators' decision
* Patients with multi-vessel disease

Exclusion Criteria:

* Other causes of shock (hypovolemia, sepsis, obstructive shock).
* Shock due to mechanical complication to MI (rupture of papillary muscle, the ventricular septum, or free wall).
* Unwitnessed out of hospital cardiac arrest with persistent Glasgow coma scale \<8 after the return of spontaneous circulation.
* Patients with single-vessel disease (Patients with single-vessel disease will be enrolled in the RESCUE-SHOCK registry)
* Onset of shock \>24 hours.
* Known heparin intolerance.
* Other severe concomitant disease with limited life expectancy \< 6 months
* Pregnancy or breast feeding
* Do not resuscitate wish

Where it's running

• Samsung Medical Center
  Seoul, South Korea Recruiting

Study contacts

• Principal investigator: Jeong Hoon Yang, MD — Samsung Medical Center
• Study coordinator: Jeong Hoon Yang, MD
• Email: jhysmc@gmail.com
• Phone: 82-2-3410-3419

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.