Abstract 15422: Trend of Stroke in Mechanical Circulatory Support Devices: Insight From the National Inpatient Sample Database

Background:Mechanical circulatory support (MCS) is increasingly being used as a bridge or destination therapy in advanced heart failure. Data on the risk of complications including stroke are limited.Methods:The National Inpatient Database (NIS) from 2002-2019 was analyzed to identify patients with stroke and classified based on MCS use into MCS and no-MCS groups. Using a linear regression model, trends of stroke were obtained.Result:On trend analysis, there was a steep increase in the incidence of stroke from 2002-2013 (MCS: 21% to 41% and no-MCS: 20% to 36%) with a decline in the trend by 2019 in MCS group compared to no-MCS group (38% vs. 44%). Annual trends of stroke in impella, extracorporeal membrane oxygenation (ECMO), intra-aortic balloon pump (IABP) and left ventricular assist device (LVAD) had initial increasing trends from 2002-2013 (1% to 18%, 2.5% to 40%, 24% to 44% and 14% to 40% respectively). Patients on LVAD had a plateaued rate from 2014-2019 (40% to 46%) while the rate in impella and ECMO continued to increase exponentially from 2014-2019 (18% to 81% and 40% to 58% respectively). Conversely, there has been a decline in the trend in IABP by 2019 (32%).Conclusion:The risk of stroke in patients with the use of mechanical circulatory support devices increased exponentially until 2013 and has shown a declining trend thereafter.