Complications from percutaneous-left ventricular assist devices versus intra-aortic balloon pump in acute myocardial infarction-cardiogenic shock

Vallabhajosyula, Saraschandra; Subramaniam, Anna V.; Murphree, Dennis H.; Patlolla, Sri Harsha; Ya’qoub, Lina; Kumar, Vinayak; Verghese, Dhiran; Cheungpasitporn, Wisit; Jentzer, Jacob C.; Sandhu, Gurpreet S.; Gulati, Rajiv; Shah, Nilay D.; Gersh, Bernard J.; Holmes, David R.; Bell, Malcolm R.; Barsness, Gregory W.

doi:10.1371/journal.pone.0238046

Cited by 17 publications

(12 citation statements)

References 42 publications

(84 reference statements)

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“…Demographic characteristics including age, sex, race, hospital characteristics, acute organ failure, MCS, cardiac procedures, and non-cardiac organ support therapies were identified for all admissions using previously used methodologies from our group ( Supplementary Table 1 ). 1 , 2 , 3 , 13 , 14 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 …”

Section: Methodsmentioning

confidence: 99%

Impact of concomitant respiratory infections in the management and outcomes acute myocardial infarction-cardiogenic shock

Patlolla

Sundaragiri²,

Cheungpasitporn

et al. 2021

Indian Heart Journal

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Objective To evaluate the prevalence and impact of respiratory infections in cardiogenic shock complicating acute myocardial infarction (AMI-CS). Methods Using the National Inpatient Sample (2000–2017), this study identified adult (≥18 years) admitted with AMI-CS complicated by respiratory infections. Outcomes of interest included in-hospital mortality of AMI-CS admissions with and without respiratory infections, hospitalization costs, hospital length of stay, and discharge disposition. Temporal trends of prevalence, in-hospital mortality and cardiac procedures were evaluated. Results Among 557,974 AMI-CS admissions, concomitant respiratory infections were identified in 84,684 (15.2%). Temporal trends revealed a relatively stable trend in prevalence of respiratory infections over the 18-year period. Admissions with respiratory infections were on average older, less likely to be female, with greater comorbidity, had significantly higher rates of NSTEMI presentation, and acute non-cardiac organ failure compared to those without respiratory infections (all p < 0.001). These admissions received lower rates of coronary angiography (66.8% vs 69.4%, p < 0.001) and percutaneous coronary interventions (44.8% vs 49.5%, p < 0.001), with higher rates of mechanical circulatory support, pulmonary artery catheterization, and invasive mechanical ventilation compared to AMI-CS admissions without respiratory infections (all p < 0.001). The in-hospital mortality was lower among AMI-CS admissions with respiratory infections (31.6% vs 38.4%, adjusted OR 0.58 [95% CI 0.57–0.59], p < 0.001). Admissions with respiratory infections had longer lengths of hospital stay (12 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 vs 6 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 days, p < 0.001), higher hospitalization costs and less frequent discharges to home (27.1% vs 44.7%, p < 0.001). Conclusions Respiratory infections in AMI-CS admissions were associated with higher resource utilization but lower in-hospital mortality.

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Section: Methodsmentioning

confidence: 99%

Impact of concomitant respiratory infections in the management and outcomes acute myocardial infarction-cardiogenic shock

Patlolla

Sundaragiri²,

Cheungpasitporn

et al. 2021

Indian Heart Journal

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“…This is particularly salient considering the higher rates of complications and adverse outcomes observed with the use of other MCS devices compared with the IABP in clinical practice. [37][38][39] Although not assessed in this study, the complication rates associated with IABP use in other studies have been low enough to potentially justify a therapeutic trial of IABP placement in selected CS patients. 4,[37][38][39] An important strength of this analysis is the inclusion of a substantial number of patients with CS due to etiologies other than ACS.…”

Section: In-hospital Mortality-multivariable Analysesmentioning

confidence: 99%

“…[37][38][39] Although not assessed in this study, the complication rates associated with IABP use in other studies have been low enough to potentially justify a therapeutic trial of IABP placement in selected CS patients. 4,[37][38][39] An important strength of this analysis is the inclusion of a substantial number of patients with CS due to etiologies other than ACS.…”

Section: In-hospital Mortality-multivariable Analysesmentioning

confidence: 99%

Influence of intra‐aortic balloon pump on mortality as a function of cardiogenic shock severity

Jentzer

Diepen

Henry

et al. 2021

Cathet Cardio Intervent

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Background: Randomized studies of intra-aortic balloon pump (IABP) in cardiogenic shock (CS) have only included on patients with acute coronary syndromes (ACS) without stratification according to shock severity. We examined the association between IABP and mortality in CS patients across the Society for Cardiovascular Angiography and Intervention (SCAI) shock stages.Methods: We included cardiac intensive care unit patients admitted from 2007 to 2015 with CS from any etiology. In-hospital mortality associated with IABP was examined in each SCAI shock stage. Multivariable logistic regression was performed using inverse probability of treatment weighting (IPTW) to determine the association between IABP and in-hospital mortality.Results: We included 934 patients, with a mean age of 68 ± 14 years; 60% had ACS.The distribution of SCAI shock stages was: B, 41%; C, 13%; D, 38%; E, 8%. In-hospital mortality was lower in the 39% of patients who received IABP (27% vs. 43%, adjusted OR with IABP after IPTW 0.53, 95% CI 0.40-0.72, p < .0001). IABP use was associated with lower crude in-hospital mortality in each SCAI shock stage (all p < .05, except p = .08 in SCAI shock stage E). We did not observe any significant heterogeneity in the association between IABP use and in-hospital mortality as a function of SCAI shock stage.Conclusions: Patients with CS who were selected to receive an IABP had lower inhospital mortality, without differences in this effect across the SCAI shock stages.Future studies should account for the severity and etiology of shock when evaluating the efficacy of IABP for CS.

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“… 63 Cardiogenic shock is also associated with decreased vascular resistance due to various proinflammatory pathways which contributes to the hypotension. 63 - 65 Vasopressors are used to maintain MAP and tissue perfusion pressures with refractory hypotension. Treatment of cardiogenic shock using pharmacologic agents must optimally balance achieving the best tissue perfusion without significantly increasing cardiac work.…”

Section: Vasoactive Medications In Cardiogenic Shockmentioning

confidence: 99%

A Clinical Update on Vasoactive Medication in the Management of Cardiogenic Shock

Shankar

Gurumurthy²,

Sridharan

et al. 2022

Clin Med Insights Cardiol

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This is a focused review looking at the pharmacological support in cardiogenic shock. There are a plethora of data evaluating vasopressors and inotropes in septic shock, but the data are limited for cardiogenic shock. This review article describes in detail the pathophysiology of cardiogenic shock, the mechanism of action of different vasopressors and inotropes emphasizing their indications and potential side effects. This review article incorporates the currently used specific risk-prediction models in cardiogenic shock as well as integrates data from many trials on the use of vasopressors and inotropes. Lastly, this review seeks to discuss the future direction for vasoactive medications in cardiogenic shock.

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Complications from percutaneous-left ventricular assist devices versus intra-aortic balloon pump in acute myocardial infarction-cardiogenic shock

Cited by 17 publications

References 42 publications

Impact of concomitant respiratory infections in the management and outcomes acute myocardial infarction-cardiogenic shock

Impact of concomitant respiratory infections in the management and outcomes acute myocardial infarction-cardiogenic shock

Influence of intra‐aortic balloon pump on mortality as a function of cardiogenic shock severity

A Clinical Update on Vasoactive Medication in the Management of Cardiogenic Shock

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