Abstract: Objective To investigate the risk factors of death from cardiac arrest after acute ST elevation myocardial infarction (STEMI) rescued by extracorporeal membrane oxygenation (ECMO) combined with emergency percutaneous coronary intervention (PCI). 
Methods A retrospective analysis was performed on the general data of 85 patients with cardiac arrest after STEMI rescued by ECMO with emergency PCI. They were followed up for 28 d. The patients were divided into death group and survival group according to their clinical outcome, and the clinical data of the two groups of patients were collected. Logistic regression analysis was used to analyze the risk factors of death from cardiac arrest patients after STEMI rescued by ECMO combined with emergency PCI. 
Results Eighty-five patients with cardiac arrest after STEMI rescued by ECMO combined with emergency PCI were followed up for 28 d. A total of 85 patients were admitted to the hospital, including 37 in the survival group and 48 in the death group, with a fatality rate of 56.47%. The ECMO transfer time and the SYNTAX score of coronary artery disease in the death group were lower than those in the survival group (P＜0.05). Length of intensive care unit (ICU) stay, acute physiology and chronic health assessment system Ⅱ (APACHEⅡ) score, cardiopulmonary resuscitation time,and the number of cases with left anterior descending branch affected were longer or higher than those of the survival group (P＜0.05). The difference of interaction between groups, time points, and time points between groups were statistically significant in terms of the net balance volume of fluid (P＜0.05). The net fluid balance at 2 and 3 d after ECMO transfer in the death group was higher than that in the survival group (P＜0.05). Logistic regression analysis showed that the ECMO transfer time, the SYNTAX score for coronary artery disease, the left anterior descending artery as the affected blood vessel, and the cumulative net fluid balance in the first 3 d after ECMO transfer were risk factors for 28-day in-hospital mortality in patients with cardiac arrest after STEMI rescued by ECMO combined with emergency PCI (P＜0.05). 
Conclusion ECMO transfer time, SYNTAX score of coronary artery disease, left anterior descending artery as affected vessel, cumulative net fluid balance in the first 3 d after ECMO transfer are all risk factors for 28-day in-hospital mortality for cardiac arrest patients after STEMI rescued by ECMO combined with emergency PCI.

Key words: ST elevation myocardial infarction, percutaneous coronary intervention, death, sudden, cardiac