{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T23:48:48Z","timestamp":1793317728706,"version":"4.5.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"vor","delay-in-days":403,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2024,10,24]],"date-time":"2024-10-24T00:00:00Z","timestamp":1729728000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>The optimal timing for implementing mechanical circulatory support (MCS) in cardiogenic shock (CS) remains indeterminate. This study aims to evaluate patient characteristics and outcome associated with the time interval between CS onset and veno-arterial extracorporeal membrane oxygenation (VA-ECMO) implementation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>In this study, patients with CS treated with MCS at 15 tertiary care centres in three countries were enrolled. Patients treated with MCS were stratified into early (&amp;lt;2\u2009h), intermediate (2\u201312\u2009h) and delayed (\u226512\u201324\u2009h) MCS implantation by using the time interval between CS onset and MCS device implementation. Adjusted logistic and Cox regression models were fitted to assess the association between timing of MCS implementation, patient characteristics and 30-day mortality. A total of 330 patients with CS treated with VA-ECMO and\/or microaxial flow pump were included in this study; 20.9% received early, 55.8% intermediate, and 23.3% delayed MCS. Although crude 30-day mortality was slightly lower in patients with early MCS (58.1% vs. 64.7% vs. 64.3%), adjusted analyses showed no significant association between timing of MCS implantation and 30-day all-cause mortality (hazard ratio [HR] for early vs. intermediate MCS: 0.93, 95% confidence interval [CI] 0.59\u20131.46, p\u2009=\u20090.74; HR for early vs. delayed MCS: 1.29, 95% CI 0.78\u20132.13, p\u2009=\u20090.33). Moreover, the incidence of complications, related and unrelated to MCS, did not differ significantly among groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this exploratory study of patients with CS treated with MCS, the timing of device implantation within 24\u2009h after CS onset was not associated with mortality. This supports a restrictive MCS approach, reserving its application for patients experiencing CS deterioration despite conventional therapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejhf.3498","type":"journal-article","created":{"date-parts":[[2024,10,24]],"date-time":"2024-10-24T03:17:16Z","timestamp":1729739836000},"page":"40-50","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Timing of Veno-Arterial Extracorporeal Membrane Oxygenation Support in Patients with Cardiogenic Shock"],"prefix":"10.1093","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0076-2211","authenticated-orcid":false,"given":"Jonas","family":"Sundermeyer","sequence":"first","affiliation":[{"name":"Department of Cardiology, University Heart and Vascular Center Hamburg , Hamburg ,","place":["Germany"]},{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Hamburg\/L\u00fcbeck\/Kiel , Hamburg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Kellner","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Heart and Vascular Center Hamburg , Hamburg ,","place":["Germany"]},{"name":"Center for Population Health Innovation (POINT), University Heart and Vascular Center, University Medical Center Hamburg-Eppendorf , Hamburg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedikt N.","family":"Beer","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Heart and Vascular Center Hamburg , Hamburg ,","place":["Germany"]},{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Hamburg\/L\u00fcbeck\/Kiel , Hamburg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Dettling","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Heart and Vascular Center Hamburg , Hamburg ,","place":["Germany"]},{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Hamburg\/L\u00fcbeck\/Kiel , Hamburg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Besch","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Heart and Vascular Center Hamburg , Hamburg ,","place":["Germany"]},{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Hamburg\/L\u00fcbeck\/Kiel , Hamburg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Blankenberg","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Heart and Vascular Center Hamburg , Hamburg ,","place":["Germany"]},{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Hamburg\/L\u00fcbeck\/Kiel , Hamburg ,","place":["Germany"]},{"name":"Center for Population Health Innovation (POINT), University Heart and Vascular Center, University Medical Center Hamburg-Eppendorf , Hamburg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingo","family":"Eitel","sequence":"additional","affiliation":[{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Hamburg\/L\u00fcbeck\/Kiel , Hamburg ,","place":["Germany"]},{"name":"University Heart Center L\u00fcbeck, University Hospital Schleswig-Holstein , L\u00fcbeck ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derk","family":"Frank","sequence":"additional","affiliation":[{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Hamburg\/L\u00fcbeck\/Kiel , Hamburg ,","place":["Germany"]},{"name":"Department of Internal Medicine III, Campus Kiel, University Hospital Schleswig-Holstein , Kiel ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norbert","family":"Frey","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, Universit\u00e4tsklinikum Heidelberg , Heidelberg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Graf","sequence":"additional","affiliation":[{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Hamburg\/L\u00fcbeck\/Kiel , Hamburg ,","place":["Germany"]},{"name":"University Heart Center L\u00fcbeck, University Hospital Schleswig-Holstein , L\u00fcbeck ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulus","family":"Kirchhof","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Heart and Vascular Center Hamburg , Hamburg ,","place":["Germany"]},{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Hamburg\/L\u00fcbeck\/Kiel , Hamburg ,","place":["Germany"]},{"name":"Center for Population Health Innovation (POINT), University Heart and Vascular Center, University Medical Center Hamburg-Eppendorf , Hamburg ,","place":["Germany"]},{"name":"Institute of Cardiovascular Sciences, University of Birmingham and UHB and SWBH NHS Trusts , Birmingham ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jannis","family":"Krais","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II, University Medical Center Regensburg , Regensburg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk","family":"von Lewinski","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Cardiology, Medical University of Graz , Graz ,","place":["Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norman","family":"Mangner","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Cardiology, Herzzentrum Dresden, Technische Universit\u00e4t Dresden , Dresden ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sven","family":"M\u00f6bius-Winkler","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, University Hospital Jena , Jena ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Nordbeck","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, University Hospital W\u00fcrzburg , W\u00fcrzburg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Orban","sequence":"additional","affiliation":[{"name":"Medizinische Klinik und Poliklinik I, Klinikum der Universit\u00e4t M\u00fcnchen , Munich ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Pauschinger","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Paracelsus Medical University N\u00fcrnberg , N\u00fcrnberg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Can Martin","family":"Sag","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II, University Medical Center Regensburg , Regensburg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clemens","family":"Scherer","sequence":"additional","affiliation":[{"name":"Medizinische Klinik und Poliklinik I, Klinikum der Universit\u00e4t M\u00fcnchen , Munich ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carsten","family":"Skurk","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Charit\u00e9 Universit\u00e4tsmedizin Berlin, Campus 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