Acute cardiac care & resuscitation
Early vs. delayed mechanical circulatory support in patients with acute myocardial infarction and cardiogenic shock
Authors' conclusion
Among patients receiving tMCS for AMI-CS, early tMCS was associated with fewer complications, shorter lengths of stay, lower hospital costs, and fewer deaths and readmissions at 30 days.
Study context
- Population
- Patients with AMI complicated by cardiogenic shock, National Readmissions Database109,148 with temporary mechanical circulatory support (tMCS)
- Participants
- 294,839 patients
- Exposure
- Early vs delayed tMCS
- Early tMCSn = 79,906
- Delayed tMCSn = 32,241reference
- Outcome
- 30-day mortality and readmission
- Follow-up
- 30 days
Main finding
As reported in the abstract
Early tMCS vs Delayed tMCSOdds ratio (95% CI)P value
Mortality
0.90(0.85–0.94)
P < 0.00130-day readmissions
0.91(0.85–0.97)
P = 0.005Observational data: associations, not effects.
Further findings
Length of stay
P < 0.001
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| In-hospital mortality, tMCS vs no tMCS | 1.7 (1.7–1.8) | P < 0.001 | |
| 0.512Odds ratio (log scale) |
Safety
- Lower rates of ischaemic and bleeding complications with early vs delayed tMCS
Original publication
Early vs. delayed mechanical circulatory support in patients with acute myocardial infarction and cardiogenic shock. Eur Heart J Acute Cardiovasc Care. Published 19 March 2024. doi:10.
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