REvaSCUlarization StratEgy of Multivessel Coronary Artery Disease for Patients with Acute Myocardial Infarction Complicated by Cardiogenic SHOCK Undergoing Veno-arterial Extracorporeal Membrane Oxygenator: Randomized-Controlled Trial (RESCUE-SHOCK)

What this Trial Is About

Researchers are investigating the best revascularization approach for patients with acute myocardial infarction (AMI) complicated by cardiogenic shock (CS) who require veno-arterial extracorporeal membrane oxygenator (VA-ECMO). This trial compares whether performing immediate multi-vessel percutaneous coronary intervention (PCI) leads to better clinical outcomes than treating only the culprit lesion in patients with multi-vessel coronary artery disease and advanced CS. The study addresses ongoing uncertainty about the benefits of non-culprit artery treatment in this high-risk patient group. Participants will be randomly assigned to one of two groups: one receiving PCI only on the culprit lesion, and the other undergoing immediate PCI on multiple vessels during the primary procedure. Randomization occurs after coronary angiography before or during primary PCI for the infarct-related artery. Both treatment approaches are performed during the primary PCI procedure while patients are supported by VA-ECMO. During the study, participants will be closely monitored for outcomes such as rates of death or advanced heart failure requiring cardiac replacement therapy within 90 days after PCI. Additional assessments include in-hospital mortality, success and timing of VA-ECMO weaning, complications, lengths of ICU stay, and various cardiac events up to 12 months after PCI. Researchers will gather detailed clinical data to evaluate safety and effectiveness, with overall participation lasting at least 90 days following the primary intervention.

Revascularization Strategy of Multivessel Disease for Patients with Acute Myocardial Infarction Complicated by Cardiogenic Shock Undergoing Veno-arterial Extracorporeal Membrane Oxygenator