Use of Mechanical Circulatory Support Devices Among Patients With Acute Myocardial Infarction Complicated by Cardiogenic Shock.
| Title: | Use of Mechanical Circulatory Support Devices Among Patients With Acute Myocardial Infarction Complicated by Cardiogenic Shock. |
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| Authors: | Dhruva SS; University of California, San Francisco School of Medicine, San Francisco.; Section of Cardiology, Department of Medicine, San Francisco Veterans Affairs Medical Center, San Francisco, California.; Ross JS; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut.; Section of General Internal Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut.; Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut.; Mortazavi BJ; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut.; Department of Computer Science and Engineering, Texas A&M University, College Station.; Center for Remote Health Technologies and Systems, Texas A&M University, College Station.; Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut.; Hurley NC; Department of Computer Science and Engineering, Texas A&M University, College Station.; Krumholz HM; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut.; Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut.; Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut.; Curtis JP; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut.; Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut.; Berkowitz AP; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut.; Masoudi FA; Division of Cardiology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora.; Messenger JC; Division of Cardiology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora.; Parzynski CS; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut.; Ngufor CG; Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota.; Division of Digital Health Sciences, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota.; Girotra S; Division of Cardiovascular Diseases, Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City.; Center for Access & Delivery Research & Evaluation (CADRE), Iowa City Veterans Affairs Medical Center, Iowa City, Iowa.; Amin AP; Cardiovascular Division, Washington University School of Medicine, St Louis, Missouri.; Shah ND; Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota.; Division of Health Care Policy Research, Mayo Clinic, Rochester, Minnesota.; Desai NR; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut.; Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut. |
| Source: | JAMA network open [JAMA Netw Open] 2021 Feb 01; Vol. 4 (2), pp. e2037748. Date of Electronic Publication: 2021 Feb 01. |
| Publication Type: | Journal Article; Research Support, U.S. Gov't, P.H.S. |
| Language: | English |
| Journal Info: | Publisher: American Medical Association Country of Publication: United States NLM ID: 101729235 Publication Model: Electronic Cited Medium: Internet ISSN: 2574-3805 (Electronic) Linking ISSN: 25743805 NLM ISO Abbreviation: JAMA Netw Open Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Chicago, IL : American Medical Association, [2018]- |
| MeSH Terms: | Extracorporeal Membrane Oxygenation/*trends ; Heart-Assist Devices/*trends ; Intra-Aortic Balloon Pumping/*trends ; Myocardial Infarction/*therapy ; Percutaneous Coronary Intervention/*methods ; Shock, Cardiogenic/*therapy; Assisted Circulation/trends ; Heart Arrest/epidemiology ; Myocardial Infarction/complications ; Shock, Cardiogenic/etiology ; Aged ; Cross-Sectional Studies ; Female ; Hospitals, High-Volume ; Hospitals, Low-Volume ; Hospitals, Teaching ; Humans ; Male ; Middle Aged ; Risk Factors |
| Abstract: | Importance: Mechanical circulatory support (MCS) devices, including intravascular microaxial left ventricular assist devices (LVADs) and intra-aortic balloon pumps (IABPs), are used in patients who undergo percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) complicated by cardiogenic shock despite limited evidence of their clinical benefit.; Objective: To examine trends in the use of MCS devices among patients who underwent PCI for AMI with cardiogenic shock, hospital-level use variation, and factors associated with use.; Design, Setting, and Participants: This cross-sectional study used the CathPCI and Chest Pain-MI Registries of the American College of Cardiology National Cardiovascular Data Registry. Patients who underwent PCI for AMI complicated by cardiogenic shock between October 1, 2015, and December 31, 2017, were identified from both registries. Data were analyzed from October 2018 to August 2020.; Exposures: Therapies to provide hemodynamic support were categorized as intravascular microaxial LVAD, IABP, TandemHeart, extracorporeal membrane oxygenation, LVAD, other devices, combined IABP and intravascular microaxial LVAD, combined IABP and other device (defined as TandemHeart, extracorporeal membrane oxygenation, LVAD, or another MCS device), or medical therapy only.; Main Outcomes and Measures: Use of MCS devices overall and specific MCS devices, including intravascular microaxial LVAD, at both patient and hospital levels and variables associated with use.; Results: Among the 28 304 patients included in the study, the mean (SD) age was 65.4 (12.6) years and 18 968 were men (67.0%). The overall MCS device use was constant from the fourth quarter of 2015 to the fourth quarter of 2017, although use of intravascular microaxial LVADs significantly increased (from 4.1% to 9.8%; P |
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| Grant Information: | U01 FD005938 United States FD FDA HHS; UL1 TR001863 United States TR NCATS NIH HHS |
| Entry Date(s): | Date Created: 20210222 Date Completed: 20210412 Latest Revision: 20210920 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC7900859 |
| DOI: | 10.1001/jamanetworkopen.2020.37748 |
| PMID: | 33616664 |
| Database: | MEDLINE |
Journal Article; Research Support, U.S. Gov't, P.H.S.