Outcomes of mechanical circulatory support for acute myocardial infarction complicated by cardiogenic shock.
Yeunjung KimKayle S ShaperoShawn S AhnAndrew M GoldsweigNihar DesaiS Elissa AltinPublished in: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions (2021)
We identified 54,480 hospitalizations for AMICS managed with MCS including 5750 (10.5%) utilizing Impella. Throughout the study period, Impella usage increased yearly to 19.9% of AMICS cases in 2017. After propensity score matching, Impella was associated with higher in-hospital mortality (odds ratio [OR] 1.74, 95% confidence interval [CI] 1.41-2.13) and transfusions (OR 1.97, 95% CI 1.40-2.78) than IABP, without association with acute kidney injury or stroke. Impella use was associated with higher hospital costs (mean difference $22,416.80 [95% CI $17,029-27,804]). Impella usage for AMICS increased significantly from 2012 to 2017 and was associated with increased in-hospital mortality and costs. Randomized controlled trials are urgently needed to assess the safety and efficacy of Impella.
Keyphrases
- extracorporeal membrane oxygenation
- left ventricular assist device
- acute myocardial infarction
- acute kidney injury
- healthcare
- atrial fibrillation
- heart failure
- emergency department
- clinical trial
- percutaneous coronary intervention
- cardiac surgery
- type diabetes
- metabolic syndrome
- adipose tissue
- coronary artery disease
- left ventricular
- acute coronary syndrome
- brain injury
- subarachnoid hemorrhage