Which Mechanical Circulatory Support Device for Patients with Myocardial Infarction and Cardiovascular Shock?

In a retrospective, propensity-score–matched study, a left ventricular assist device was associated with worse in-hospital outcomes after PCI than the intra-aortic balloon pump.

Cardiogenic shock complicating acute myocardial infarction (AMI) has very high associations with mortality. When these patients undergo percutaneous coronary intervention (PCI), intravascular microaxial left ventricular assist devices (LVADs) improve hemodynamic parameters better than the intra-aortic balloon pump (IABP), but a mortality benefit with LVAD has not been demonstrated. To compare outcomes of the two approaches, researchers using two national registries identified 28,304 AMI patients with cardiogenic shock between 2015 and 2017.

Among patients who received only an LVAD (6%) or only IABP (30%), the authors propensity-score–matched 1680 pairs according to baseline characteristics. LVAD was associated with a higher risk for in-hospi…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI

Leadership Positions in Professional SocietiesHeart Valve Collaboratory (Scientific Committee Member, Chair of the Publications Committee)