Prognosis in Patients With Cardiogenic Shock Who Received Temporary Mechanical Circulatory Support.
JACC Asia
; 3(1): 122-134, 2023 Feb.
Article
in En
| MEDLINE
| ID: mdl-36873766
ABSTRACT
Background:
Temporary mechanical circulatory support (MCS) is often used in patients with cardiogenic shock (CS), and the type of MCS may vary by cause of CS.Objectives:
This study sought to describe the causes of CS in patients receiving temporary MCS, the types of MCS used, and associated mortality.Methods:
This study used a nationwide Japanese database to identify patients receiving temporary MCS for CS between April 1, 2012, and March 31, 2020.Results:
Of 65,837 patients, the cause of CS was acute myocardial infarction (AMI) in 77.4%, heart failure (HF) in 10.9%, valvular disease in 2.7%, fulminant myocarditis (FM) in 2.5%, arrhythmia in 4.5%, and pulmonary embolism (PE) in 2.0% of cases. The most commonly used MCS was an intra-aortic balloon pump alone in AMI (79.2%) and in HF (79.0%) and in valvular disease (66.0%), extracorporeal membrane oxygenation with intra-aortic balloon pump in FM (56.2%) and arrhythmia (43.3%), and extracorporeal membrane oxygenation alone in PE (71.5%). Overall in-hospital mortality was 32.4%; 30.0% in AMI, 32.6% in HF, 33.1% in valvular disease, 34.2% in FM, 60.9% in arrhythmia, and 59.2% in PE. Overall in-hospital mortality increased from 30.4% in 2012 to 34.1% in 2019. After adjustment, valvular disease, FM, and PE had lower in-hospital mortality than AMI valvular disease, OR 0.56 (95% CI 0.50-0.64); FM OR 0.58 (95% CI 0.52-0.66); PE OR 0.49 (95% CI 0.43-0.56); whereas HF had similar in-hospital mortality (OR 0.99; 95% CI 0.92-1.05) and arrhythmia had higher in-hospital mortality (OR 1.14; 95% CI 1.04-1.26).Conclusions:
In a Japanese national registry of patients with CS, different causes of CS were associated with different types of MCS and differences in survival.
AMI, acute myocardial infarction; CS, cardiogenic shock; ECMO, extracorporeal membrane oxygenation; FM, fulminant myocarditis; HF, heart failure; IABP, intra-aortic balloon pump; ICD-10, International Classification of Diseases-10th Revision; MCS, mechanical circulatory support; OR, odds ratio; PE, pulmonary embolism; cardiogenic shock; extracorporeal membrane oxygenation; intra-aortic balloon pump; mechanical circulatory support; pVAD, percutaneous ventricular assist device; percutaneous ventricular assist device
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Type of study:
Prognostic_studies
Language:
En
Journal:
JACC Asia
Year:
2023
Document type:
Article