Cardio Round-up: Awake ECMO; Heart Disease Risk for Expectant Mothers; and More

Risk factors for heart disease put expectant mothers at higher risk for adverse pregnancy outcomes (APO) as well as increased chances of high blood pressure years after delivery, according to a recent study published online in the Journal of the American Heart Association. The researchers found that women with an APO/gestational diabetes mellitus (1,102 women) had more atherogenic characteristics (obesity; higher blood pressure, diastolic blood pressure, glucose, insulin, triglycerides, and high-sensitivity C-reactive protein; lower high-density lipoprotein cholesterol) versus women without an APO/gestational diabetes mellitus.

A new study suggests that the use of and ‘awake’ management strategy of venoarterial extracorporeal membrane oxygenation (VA-ECMO) for cardiogenic shock is safe and effective. The study was conducted as a propensity score-matched analysis of a data from 7-year database of patients given peripheral VA-ECMO support. The patient population included 213 patients, 91 of whom were awake and 140 who were non-awake. After adjusting for propensity-matching, the patients in the awake VA-ECMO group had lower rates of pneumonia, tracheostomy, renal replacement therapy, and less antibiotic and sedative consumption. The authors also reported a reduction in 60-day (P=0.018) and 1-year mortality rates (P=0.021) compared to the non-awake group.

Patients who experience ST-elevation myocardial infarction (STEMI) after transcatheter aortic valve replacement (TAVR) tend to have higher mortality rates and worse outcomes, a new study suggests. The multicenter study included included 118 patients presenting with STEMI after TAVR (median of 255 days). The authors compared all-comer STEMI to procedural features of STEM after TAVR managed with percutaneous coronary intervention (PCI). The authors reported that median door-to-balloon time was higher in TAVR patients, along with longer procedural times, fluoroscopy times, dose-area product, and contrast volume (P<0.01 for all). Additionally, PCI failure occurred more frequently in TAVR recipients (P<0.001). In-hospital and late mortality rates were high in TAVR patients, as was Killip class ≥2 and PCI failure.