Impact of the Timing of Mechanical Circulatory Support on the Outcomes in Myocardial Infarction-Related Cardiogenic Shock: Subanalysis of the PREPARE CS Registry

被引：2

作者：

Prunea, Dan M. ^{[1
,2
]}

Bachl, Eva ^{[1
]}

Herold, Lukas ^{[1
]}

Schnur, Sadeek S. Kanoun ^{[1
,3
,4
]}

Paetzold, Sascha ^{[1
]}

Altmanninger-Sock, Siegfried ^{[1
]}

Sommer, Gudrun A. ^{[1
]}

Glantschnig, Theresa ^{[1
]}

Kolesnik, Ewald ^{[1
]}

Wallner, Markus ^{[1
]}

Ablasser, Klemens ^{[1
]}

Bugger, Heiko ^{[1
]}

Buschmann, Eva ^{[1
]}

Praschk, Andreas ^{[1
]}

Fruhwald, Friedrich M. ^{[1
]}

Schmidt, Albrecht ^{[1
]}

von Lewinski, Dirk ^{[1
]}

Toth, Gabor G. ^{[1
]}

机构：

[1] Med Univ Graz, Dept Cardiol, A-8010 Graz, Austria

[2] Univ Med & Pharm Iuliu Ha?ieganu, Niculae Stancioiu Heart Inst, Cluj Napoca 400347, Romania

[3] Univ Szeged, Fac Med, Doctoral Sch Clin Med, H-6720 Szeged, Hungary

[4] Royal Devon Univ Healthcare NHS Fdn Trust, Exeter EX2 5DW, England

来源：

JOURNAL OF CLINICAL MEDICINE | 2024年 / 13卷 / 06期

关键词：

cardiogenic shock; mechanical circulatory support; myocardial infarction; mechanical circulatory support timing; in-hospital mortality; MANAGEMENT; PUMP;

D O I：

10.3390/jcm13061552

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

(1) Background: Mechanical circulatory support (MCS) in myocardial infarction-associated cardiogenic shock is subject to debate. This analysis aims to elucidate the impact of MCS's timing on patient outcomes, based on data from the PREPARE CS registry. (2) Methods: The PREPARE CS prospective registry includes patients who experienced cardiogenic shock (SCAI classes C-E) and were subsequently referred for cardiac catheterization. Our present analysis included a subset of this registry, in whom MCS was used and who underwent coronary intervention due to myocardial infarction. Patients were categorized into an Upfront group and a Procedural group, depending on the timing of MCS's introduction in relation to their PCI. The endpoint was in-hospital mortality. (3) Results: In total, 71 patients were included. MCS was begun prior to PCI in 33 (46%) patients (Upfront), whereas 38 (54%) received MCS during or after the initiation of PCI (Procedural). The groups' baseline characteristics and hemodynamic parameters were comparable. The Upfront group had a higher utilization of the Impella (R) device compared to extracorporeal membrane oxygenation (67% vs. 33%), while the Procedural group exhibited a balanced use of both (50% vs. 50%). Most patients suffered from multi-vessel disease in both groups (82% vs. 84%, respectively; p = 0.99), and most patients required a complex PCI procedure; the latter was more prevalent in the Upfront group (94% vs. 71%, respectively; p = 0.02). Their rates of complete revascularization were comparable (52% vs. 34%, respectively; p = 0.16). Procedural CPR was significantly more frequent in the Procedural group (45% vs. 79%, p < 0.05); however, in-hospital mortality was similar (61% vs. 79%, respectively; p = 0.12). (4) Conclusions: The upfront implantation of MCS in myocardial infarction-associated CS did not provide an in-hospital survival benefit.

引用

页数：11