Trends and outcomes of different mechanical circulatory support modalities for acute myocardial infarction associated cardiogenic shock in patients undergoing early revascularization.
Publication/Presentation Date
10-1-2024
Abstract
BACKGROUND: The use of Mechanical Circulatory Support (MCS) devices in cardiogenic shock (CS) is growing. However, the recent trends in using different MCS modalities and their outcomes in acute myocardial infarction associated CS (AMI-CS) are unknown.
METHODS: The national readmission database (2016-2020) was used to identify AMI-CS requiring MCS. Cohorts were stratified as ECMO compared to Impella. Propensity score matching (PSM) was used to remove confounding factors. Pearson's x2 test was applied to matched cohorts to compare outcomes. We used multivariate regression and reported predictive margins for adjusted trend analysis.
RESULTS: Among 20,950 AMI-CS hospitalizations requiring MCS, 19,628 (93.7 %) received Impella vs 1322 (6.3 %) were placed only on ECMO. ECMO group was younger (median age: 61 vs. 68 years,
CONCLUSION: Despite advances in MCS modalities, the overall mortality rate for AMI-CS remains unchanged. ECMO use without LV unloading showed higher mortality and adverse events compared to Impella. Prospective studies are needed to verify these findings.
Volume
46
First Page
100468
Last Page
100468
ISSN
2666-6022
Published In/Presented At
Ali, S., Kumar, M., Badu, I., Farooq, F., Alsaeed, T., Sultan, M., Atti, L., Duhan, S., Agrawal, P., Brar, V., Helmy, T., & Tayeb, T. (2024). Trends and outcomes of different mechanical circulatory support modalities for acute myocardial infarction associated cardiogenic shock in patients undergoing early revascularization. American heart journal plus : cardiology research and practice, 46, 100468. https://doi.org/10.1016/j.ahjo.2024.100468
Disciplines
Medicine and Health Sciences
PubMedID
39431117
Department(s)
Fellows and Residents
Document Type
Article