Acute cardiac care & resuscitationCohort study
Prognostic Implications of Bleeding and Ischemic Complications in Acute Myocardial Infarction-Related Cardiogenic Shock Managed With Microaxial Flow Pump
- Registry analysis
- J-PVAD (Japan Registry for Percutaneous Ventricular Assist Device)
- Cox regression with time-varying exposures
- death as a competing event
Authors' conclusion
Both bleeding and ischemic complications remain frequent adverse events in acute myocardial infarction-related cardiogenic shock requiring a microaxial flow pump. While both complications were significantly associated with mortality, the higher incidence of bleeding complications contributed to a greater mortality burden. This underscores the importance of bleeding prevention strategies alongside ischemic complication management in this high-risk population.
Study context
- Population
- Patients who underwent microaxial flow pump implantation for acute myocardial infarction-related cardiogenic shock between 2020 and 2023mean age, 69.2±11.7 years, 17.6% women
- Participants
- 2,034 patients
- Exposure
- Associations between complications and mortality, adjusting for clinical characteristics
- Outcome
- In-hospital all-cause mortality
- Follow-up
- During hospitalization
Main finding
As reported in the abstract
Adjusted hazard ratio (95% CI)
Bleeding complications
1.60(1.30–1.97)
Ischemic complications
1.74(1.24–2.44)
- Died during hospitalization
- 840 (41.3%)
Observational data: associations, not effects.
Further findings
| Outcome | Bleeding complications | Ischemic complications |
|---|---|---|
| 30-day cumulative incidence of complications | cumulative incidence 23.2% (95% CI 21.4%–25.0%) | cumulative incidence 10.5% (95% CI 9.1%–11.8%) |
| Population attributable fraction for death | population attributable fraction 10.7% (95% CI 6.6%–14.0%) | population attributable fraction 4.0% (CI 1.8%–5.6%) |
Original publication
Prognostic Implications of Bleeding and Ischemic Complications in Acute Myocardial Infarction-Related Cardiogenic Shock Managed With Microaxial Flow Pump. Circ Cardiovasc Interv. Published 29 March 2026. doi:10.1161/circinterventions.125.015676
Summarised from the published abstract; every number is checked against it