University of Leicester is leading the way in Cardiogenic Shock treatment

Led by the University of Leicester, 12 university hospitals have set up a pan-European recruiting network with 45 cardiovascular centres to test early Extra Corporeal Membrane Oxygenation (ECMO) in patients with cardiogenic shock.

An extensive network of the foremost cardio-vascular hospitals from nine European countries are working together in the EURO SHOCK trial to determine the efficacy and cost benefit of very early ECMO in patients with cardiogenic shock.

On Wednesday 12 December 2018, investigators gathered at the Royal Society of Medicine in London for the last preparations before the trial begins. The recruitment target is to randomise more than 400 patients in 34 months starting from Friday 1 February 2019.

This is a Leicester University sponsored trial led by Chief Investigator, Professor Anthony Gershlick, from University Hospitals of Leicester and the University of Leicester, who secured 6.4 million Euros in funding from the Horizons 2020 project to run the trial and all of the administrative support needed for a pan-European study.

Professor Gershlick said: “The reason for the successful funding was that every year across Europe more than 50,000 patients are diagnosed with cardiogenic shock.

“Women and the elderly are at highest risk to this severe condition, which is a complex and hemodynamically diverse state of end-organ hypoperfusion.

“Because the majority of patients with cardiogenic shock end up with multisystem organ failure, at current, the mortality rate for this condition is still 50% for the first 30 days after a the onset of cardiogenic shock.”

The last major breakthrough in this domain dates from almost 20 years ago.

Despite several more recent attempts to improve survival of this patient population, no new evidence-based therapeutic interventions known to improve patient outcomes significantly have been introduced during the last years.

The EU-funded EURO SHOCK project is the first large-scale clinical trial investigating ECMO as a potential intervention to reduce mortality associated with cardiogenic shock.

ECMO is a form of mechanical circulatory support where deoxygenated blood is withdrawn from the patient at the venous site, and after being enriched with oxygen, administered directly to the arterial system, thereby preserving the body’s critical organs during the phase of most critical disease.

In this Europe-wide trial, patients will receive immediate revascularisation to open the blocked artery that is causing the heart attack and then, following consent, be randomised to receive standard pharmacotherapy or standard pharmacotherapy plus ECMO deployment within a few hours after diagnosis of cardiogenic shock.

Professor Gershlick added: “The collaborative nature of the project with the single goal of improving patient outcomes in this dreadful condition was perhaps the most exciting aspects of the kick-off meeting which was attended by representatives from each centre. Everyone is driven to make a beneficial impact.”