Acute cardiac care & resuscitation
Variation in mechanical circulatory support use for acute myocardial infarction cardiogenic shock
Authors' conclusion
The present study identified wide interhospital variation in the use of IABP and PVAD for AMI CS. Although the likelihood of escalation to ECMO or LVAD differed between hospital types, resource utilisation was similar.
Study context
- Population
- Non-elective adult hospitalisations entailing AMI and CS
- Participants
- 53,903 patients
- Exposure
- Interhospital variation in the use of intra-aortic balloon pump (IABP) and percutaneous ventricular assist device (PVAD) for AMI CS; high-PVAD vs high-IABP hospitals
- Outcome
- Interhospital variation in the use of IABP and PVAD (variation attributable to centre-level differences, after adjustment for patient factors)
Main finding
As reported in the abstract
IABP use attributable to centre-level differences
≈13%
11–14%
PVAD use attributable to centre-level differences
18%
15–20%
Observational data: associations, not effects.
Further findings
| Outcome | Values | Estimate | P value |
|---|---|---|---|
| Device use | IABP 23.4% · PVAD 12.5% | ||
| Annual PCI volumeHigh-PVAD hospitals vs high-IABP hospitals · higher with high-PVAD hospitals | High-PVAD hospitals 257 (185-369) cases/year · high-IABP hospitals 204 (148-276) cases/year | P = 0.032 | |
| Safety net institutionsHigh-PVAD hospitals vs high-IABP hospitals · more common with high-PVAD hospitals | High-PVAD hospitals 27.4% · high-IABP hospitals 11.3% | P = 0.023 | |
| Length of stayhigh-IABP hospitals vs high-PVAD hospitals | β −0.16 (95% CI −1.82 to 1.49) | ||
| Costshigh-IABP hospitals vs high-PVAD hospitals · similar | β -$3500 (95% CI −16 600 to 9600) | ||
| Escalation to ECMOHigh-PVAD hospitals vs high-IABP hospitals · lower adjusted risk at high-PVAD hospitals | 0.52 (95% CI 0.29–0.95) | ||
| LVAD implantationHigh-PVAD hospitals vs high-IABP hospitals · lower adjusted risk at high-PVAD hospitals | 0.28 (95% CI 0.08–0.94) |
Original publication
Variation in mechanical circulatory support use for acute myocardial infarction cardiogenic shock. Heart. Published 24 August 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →