Garan AR, Malick WA, Habal M, et al. - Given the possibility of requiring short-term mechanical circulatory support in correlation to occurrence of cardiogenic shock among cases with chronic systolic heart failure (HF) with acute decompensation, researchers investigated the predictors of survival for acute decompensated HF (ADHF) patients requiring veno-arterial extracorporeal membrane oxygenation (VA-ECMO). They studied 52 patients (> 18 years) treated at their institution with VA-ECMO from 2009 to 2018 for ADHF with CS. Of these, 24 (46.2%) survived, cardiac arrest occurred in 17 (32.7%), and mechanical ventilation was provided to 37 (71.2%). Durable ventricular assist device was required in 19 (79.2%) survivors. Multivariable analysis revealed diabetes mellitus(DM) and mineralocorticoid receptor antagonist use as the only independent predictors of mortality. DM, but not markers of clinical acuity including hemodynamics, vasopressor/inotrope use, and lactate, is powerful predictor of outcomes among ADHF patients receiving VA-ECMO.