{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T10:56:51Z","timestamp":1788173811358,"version":"build-2803163510"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2023,5,16]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Despite the benefit of culprit\u2010only percutaneous coronary intervention (PCI) in the CULPRIT\u2010SHOCK (Culprit Lesion Only PCI Versus Multi\u2010vessel PCI in Cardiogenic Shock) trial, the optimal revascularization strategy for refractory cardiogenic shock (CS) requiring mechanical circulatory support devices remains controversial. This study aimed to compare clinical outcomes between the culprit\u2010only and immediate multivessel PCI strategies in patients with acute myocardial infarction complicated by CS who underwent venoarterial\u2010extracorporeal membrane oxygenation before revascularization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      This study included\u00a0patient\u2010pooled data from the RESCUE (Retrospective and Prospective Observational Study to Investigate Clinical Outcomes and Efficacy of Left Ventricular Assist Devices for Korean Patients With Cardiogenic Shock) and SMC\u2010ECMO (Samsung Medical Center\u2013Extracorporeal Membrane Oxygenation) registries. A total of 315 patients with acute myocardial infarction with multivessel disease who underwent venoarterial\u2010extracorporeal membrane oxygenation before revascularization attributable to refractory CS were included in this analysis. The study population was classified into culprit\u2010only versus immediate multivessel PCI according to nonculprit lesion treatment strategies. The primary end point was 30\u2010day mortality or renal\u2010replacement therapy, and the key secondary end point was 12\u2010month follow\u2010up mortality. Among the study population, 175 (55.6%) underwent culprit\u2010only PCI and 140 (44.4%) underwent immediate multivessel PCI. Compared with culprit\u2010only PCI, immediate multivessel PCI was associated with significantly lower risks of 30\u2010day mortality or renal\u2010replacement therapy (68.0% versus 54.3%;\n                      <jats:italic>P<\/jats:italic>\n                      =0.018) and all\u2010cause mortality during 12 months of follow\u2010up (59.5% versus 47.5%; hazard ratio [HR], 0.689 [95% CI, 0.506\u20130.939];\n                      <jats:italic>P<\/jats:italic>\n                      =0.018) in patients with acute myocardial infarction and CS who underwent venoarterial\u2010extracorporeal membrane oxygenation before revascularization. These results were also consistent in the 99 pairs of propensity score\u2013matched population (60.6% versus 43.6%; HR, 0.622 [95% CI, 0.420\u20130.922];\n                      <jats:italic>P<\/jats:italic>\n                      =0.018).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Among patients with acute myocardial infarction with multivessel disease complicated by advanced CS requiring venoarterial\u2010extracorporeal membrane oxygenation before revascularization, immediate multivessel PCI was associated with lower incidences of 30\u2010day mortality or renal replacement therapy and 12\u2010month follow\u2010up mortality, compared with culprit\u2010only PCI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Registration Information<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/clinicaltrials.gov\">clinicaltrials.gov<\/jats:ext-link>\n                      . Identifier: NCT02985008.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.123.029792","type":"journal-article","created":{"date-parts":[[2023,5,9]],"date-time":"2023-05-09T07:11:57Z","timestamp":1683616317000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":15,"title":["Culprit\u2010Only Versus Immediate Multivessel Percutaneous Coronary Intervention in Patients With Acute Myocardial Infarction Complicating Advanced Cardiogenic Shock Requiring Venoarterial\u2010Extracorporeal Membrane Oxygenation"],"prefix":"10.1161","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7511-9581","authenticated-orcid":false,"given":"Ki Hong","family":"Choi","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8138-1367","authenticated-orcid":false,"given":"Jeong Hoon","family":"Yang","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1440-3583","authenticated-orcid":false,"given":"Taek Kyu","family":"Park","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2178-4014","authenticated-orcid":false,"given":"Joo Myung","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3986-9152","authenticated-orcid":false,"given":"Young Bin","family":"Song","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4412-377X","authenticated-orcid":false,"given":"Joo\u2010Yong","family":"Hahn","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0304-6317","authenticated-orcid":false,"given":"Seung\u2010Hyuk","family":"Choi","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7071-4370","authenticated-orcid":false,"given":"Chul\u2010Min","family":"Ahn","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Severance Cardiovascular Hospital Yonsei University College of Medicine Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5871-4562","authenticated-orcid":false,"given":"Cheol Woong","family":"Yu","sequence":"additional","affiliation":[{"name":"Division of Cardiology, 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