Acute cardiac care & resuscitationResearch article
Comparative Effectiveness of Percutaneous Microaxial Left Ventricular Assist Device vs Intra-Aortic Balloon Pump or No Mechanical Circulatory Support in Patients With Cardiogenic Shock
- Comparative effectiveness research study
- Medicare fee-for-service claims
- inverse probability of treatment weighting
- instrumental variable analysis
- instrumented difference-in-differences analysis
- grace period approach
Authors' conclusion
In observational analyses comparing the percutaneous microaxial LVAD to alternative treatments among patients with AMICS, the percutaneous microaxial LVAD was associated with worse outcomes in some analyses, while in other analyses, the association was too imprecise to draw meaningful conclusions.
Study context
- Population
- Medicare patients admitted with acute MI with cardiogenic shock undergoing PCI, October 1, 2015, through December 31, 2019
- Participants
- 23,478 patients
- Comparison
- Percutaneous microaxial left ventricular assist device (LVAD) vs alternative treatments
- Outcome
- All-cause mortality and readmissions
- Follow-up
- 30 days
Main finding
As reported in the abstract
30-day mortality
Percutaneous microaxial LVAD vs Alternative treatmentsRisk difference (95% CI)
inverse probability of treatment weighting and grace period analyses; risk-adjusted; possible confounding by illness severity
14.9%(12.9%–17.0%)
instrumental variable analysis; possible confounding by unmeasured variables
13.5%(3.9%–23.2%)
Original publication
Comparative Effectiveness of Percutaneous Microaxial Left Ventricular Assist Device vs Intra-Aortic Balloon Pump or No Mechanical Circulatory Support in Patients With Cardiogenic Shock. JAMA Cardiol. Published 1 August 2023. doi:10.1001/jamacardio.2023.1643
Summarised from the published abstract; every number is checked against it