1. Impella Versus Extracorporeal Membrane Oxygenation for Acute Myocardial Infarction Cardiogenic Shock.
- Author
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Lemor, Alejandro, Hosseini Dehkordi, Seyed Hamed, Basir, Mir B., Villablanca, Pedro A., Jain, Tarun, Koenig, Gerald C., Alaswad, Khaldoon, Moses, Jeffrey W., Kapur, Navin K., and O'Neill, William
- Subjects
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MYOCARDIAL infarction , *CARDIOGENIC shock , *LENGTH of stay in hospitals , *HEART assist devices , *EXTRACORPOREAL membrane oxygenation , *HOSPITAL costs , *INTRA-aortic balloon counterpulsation - Abstract
Background: Percutaneous ventricular assist devices and extracorporeal membrane oxygenation (ECMO) are increasingly used for mechanical circulatory support (MCS) in patients with acute myocardial infarction with cardiogenic shock (AMI-CS) in hospitals throughout the United States.Methods: Using the National Inpatient Sample from October 2015 to December 2017, we identified hospital admissions that underwent percutaneous coronary intervention (PCI) and non-elective Impella or ECMO placement for AMI-CS using ICD-10 codes. Propensity-score matching was performed to compare both groups for primary and secondary outcomes.Results: We identified 6290 admissions for AMI-CS who underwent PCI and were treated with Impella (n = 5730, 91%) or ECMO (n = 560, 9%) from October 2015 to December 2017. After propensity-match analysis, the ECMO cohort had significantly higher in-hospital mortality (43.3% vs 26.7%, OR: 2.10, p = 0.021). The incidence of acute respiratory failure and vascular complications were significantly lower in the Impella cohort. We observed a shorter duration of hospital stay and lower hospital costs in the Impella cohort compared to those who received ECMO.Conclusions: In AMI-CS, the use of Impella was associated with better clinical outcomes, fewer complications, shorter length of hospital stay and lower hospital cost compared to those undergoing ECMO placement. [ABSTRACT FROM AUTHOR]- Published
- 2020
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