Mechanical circulatory support center volume and outcomes in infarct-related cardiogenic shock: the ECLS-SHOCK trial

Cardiogenic shock (CS) occurs in up to 10% of patients with acute myocardial infarction (AMI) and remains associated with an excessively high early mortality.1 For haemodynamic stabilization in AMI-CS, the use of extracorporeal life support (ECLS) has significantly increased over the past decade.2 Several factors may influence outcomes of patients receiving ECLS including patient selection and also centre experience.3,4 While some mainly retrospective studies suggest that treatment in high-volume centres does not necessarily lead to lower mortality or may even be associated with higher mortality, other data indicate that a higher CS case volume is linked to improved survival.5–8 Therefore, we conducted a post hoc analysis of the ECLS-SHOCK trial to assess the potential associations between mechanical circulatory support (MCS) centre volume and both short- and long-term clinical outcomes. The trial design, including eligibility criteria, informed consent process, data collection, 30-day, and 1-year outcomes has been published previously.3,9