Early Utilization of Mechanical Circulatory Support in Acute Myocardial Infarction Complicated by Cardiogenic Shock: The National Cardiogenic Shock Initiative

被引：43

作者：

Basir, Mir B. ^{[1
,2
]}

Lemor, Alejandro ^{[3
]}

Gorgis, Sarah ^{[2
]}

Patel, Kirit C. ^{[4
]}

Kolski, Brian C. ^{[5
]}

Bharadwaj, Aditya S. ^{[6
]}

Todd, Joshua W. ^{[7
]}

Tehrani, Behnam N. ^{[8
]}

Truesdell, Alexander G. ^{[8
]}

Lasorda, David M. ^{[9
]}

Lalonde, Thomas A. ^{[10
]}

Kaki, Amir ^{[10
]}

Schrieber, Theodore L. ^{[10
]}

Patel, Nainesh C. ^{[11
]}

Senter, Shaun R. ^{[12
]}

Gelormini, Joseph L. ^{[13
]}

Marso, Steven P. ^{[14
]}

Rahman, Ayaz M. ^{[15
]}

Federici, Robert E. ^{[16
]}

Wilkins, Charles E. ^{[17
]}

Thomas McRae, A. ^{[18
]}

Nsair, Ali ^{[19
]}

Caputo, Christopher P. ^{[20
]}

Khuddus, Matheen A. ^{[20
]}

Chahin, Juan J. ^{[21
]}

Dupont, Allison G. ^{[22
]}

Goldsweig, Andrew M. ^{[23
]}

Lim, Michael J. ^{[24
]}

Kapur, Navin K. ^{[25
]}

Wohns, David H. W. ^{[26
]}

Zhou, Yueren ^{[2
]}

Hacala, Michael J. ^{[2
]}

O'Neill, William W. ^{[2
]}

机构：

[1] Henry Ford Hosp, Acute Mech Circulatory Support, 2799 West Grand Blvd,K-2-Cath Lab, Detroit, MI 48188 USA

[2] Henry Ford Hosp, Detroit, MI USA

[3] Univ Mississippi, Jackson, MS USA

[4] St Joseph Mercy, Oakland, MI USA

[5] St Joseph Hosp Orange, Orange, CA USA

[6] Loma Linda Univ, Med Ctr, Loma Linda, CA USA

[7] Ft Sanders Reg Med Ctr, Ft Sanders, TN USA

[8] Inova Fairfax Hosp, Fairfax, VA USA

[9] Allegheny Gen Hosp, Pittsburgh, PA USA

[10] Ascens St John Hosp, Detroit, MI USA

[11] Lehigh Valley Hosp, Allentown, PA USA

[12] Washington Reg Med Ctr, Washington, AK USA

[13] Mercy Hosp, Buffalo, NY USA

[14] Overland Pk Reg Med Ctr, Overland Pk, KS USA

[15] Parkwest Med Ctr, Knoxville, TN USA

[16] Presbyterian Hosp, Albuquerque, NM USA

[17] San Juan Reg Med Ctr, San Juan, NM USA

[18] TriStar Centennial Med Ctr, Nashville, TN USA

[19] Ronald Reagan UCLA Med Ctr, Los Angeles, CA USA

[20] North Florida Reg Med Ctr, Gainesville, FL USA

[21] Excela Hlth Westmoreland Hosp, Greensburg, PA USA

[22] Northside Cardiovasc Inst, Atlanta, GA USA

[23] Baystate Med Ctr, Springfield, MA USA

[24] Hackensack Med Ctr, Hackensack, NJ USA

[25] Tufts Med Ctr, Boston, MA USA

[26] Spectrum Hlth Butterworth Hosp, Grand Rapids, MI USA

来源：

JOURNAL OF THE AMERICAN HEART ASSOCIATION | 2023年 / 12卷 / 23期

关键词：

acute myocardial infarction; cardiogenic shock; Impella; mechanical circulatory support; percutaneous coronary intervention; pulmonary artery catheter; TRIAL;

D O I：

10.1161/JAHA.123.031401

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BackgroundAcute myocardial infarction complicated by cardiogenic shock (AMI-CS) is associated with significant morbidity and mortality. Mechanical circulatory support (MCS) devices increase systemic blood pressure and end organ perfusion while reducing cardiac filling pressures.Methods and ResultsThe National Cardiogenic Shock Initiative (NCT03677180) is a single-arm, multicenter study. The purpose of this study was to assess the feasibility and effectiveness of utilizing early MCS with Impella in patients presenting with AMI-CS. The primary end point was in-hospital mortality. A total of 406 patients were enrolled at 80 sites between 2016 and 2020. Average age was 64 +/- 12 years, 24% were female, 17% had a witnessed out-of-hospital cardiac arrest, 27% had in-hospital cardiac arrest, and 9% were under active cardiopulmonary resuscitation during MCS implantation. Patients presented with a mean systolic blood pressure of 77.2 +/- 19.2 mm Hg, 85% of patients were on vasopressors or inotropes, mean lactate was 4.8 +/- 3.9 mmol/L and cardiac power output was 0.67 +/- 0.29 watts. At 24 hours, mean systolic blood pressure improved to 103.9 +/- 17.8 mm Hg, lactate to 2.7 +/- 2.8 mmol/L, and cardiac power output to 1.0 +/- 1.3 watts. Procedural survival, survival to discharge, survival to 30 days, and survival to 1 year were 99%, 71%, 68%, and 53%, respectively.ConclusionsEarly use of MCS in AMI-CS is feasible across varying health care settings and resulted in improvements to early hemodynamics and perfusion. Survival rates to hospital discharge were high. Given the encouraging results from our analysis, randomized clinical trials are warranted to assess the role of utilizing early MCS, using a standardized, multidisciplinary approach.

引用

页数：11

共 23 条

[1] Feasibility of Early Mechanical Circulatory Support in Acute Myocardial Infarction Complicated by Cardiogenic Shock: The Detroit Cardiogenic Shock Initiative [J].

Basir, Mir ;

Schreiber, Theodore ;

Dixon, Simon ;

Alaswad, Khaldoon ;

Patel, Kiritkumar ;

Almany, Steven ;

Khandelwal, Akshay ;

George, Augustine ;

Ashbrook, Michael ;

Blank, Nimrod ;

Sareen, Nishtha ;

O'Neill, William .

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2017, 70 (18) :B43-B44

[2] Vasopressors independently associated with mortality in acute myocardial infarction and cardiogenic shock [J].

Basir, Mir B. ;

Lemor, Alejandro ;

Gorgis, Sarah ;

Taylor, Angela M. ;

Tehrani, Behnam ;

Truesdell, Alexander G. ;

Bharadwaj, Aditya ;

Kolski, Brian ;

Patel, Kirit ;

Gelormini, Joseph ;

Todd, Josh ;

Lasorda, David ;

Smith, Craig ;

Riley, Robert ;

Marso, Steve ;

Federici, Robert ;

Kapur, Navin K. ;

O'Neill, William W. .

CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, 2022, 99 (03) :650-657

[3] Mechanical circulatory support in acute myocardial infarction and cardiogenic shock: Challenges and importance of randomized control trials [J].

Basir, Mir B. ;

Pinto, Duane S. ;

Ziaeian, Boback ;

Khandelwal, Akshay ;

Cowger, Jennifer ;

Suh, William ;

Althouse, Andrew .

CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, 2021, 98 (07) :1264-1274

[4] Effect of Early Initiation of Mechanical Circulatory Support on Survival in Cardiogenic Shock [J].

Basir, Mir B. ;

Schreiber, Theodore L. ;

Grines, Cindy L. ;

Dixon, Simon R. ;

Moses, Jeffrey W. ;

Maini, Brijeshwar S. ;

Khandelwal, Akshay K. ;

Ohman, E. Magnus ;

O'Neill, William W. .

AMERICAN JOURNAL OF CARDIOLOGY, 2017, 119 (06) :845-851

[5] Clinical Practice Patterns in Temporary Mechanical Circulatory Support for Shock in the Critical Care Cardiology Trials Network (CCCTN) Registry [J].

Berg, David D. ;

Barnett, Christopher F. ;

Kenigsberg, Benjamin B. ;

Papolos, Alexander ;

Alviar, Carlos L. ;

Baird-Zars, Vivian M. ;

Barsness, Gregory W. ;

Bohula, Erin A. ;

Brennan, Joseph ;

Burke, James A. ;

Carnicelli, Anthony P. ;

Chaudhry, Sunit-Preet ;

Cremer, Paul C. ;

Daniels, Lori B. ;

DeFilippis, Andrew P. ;

Gerber, Daniel A. ;

Granger, Christopher B. ;

Hollenberg, Steven ;

Horowitz, James M. ;

Gladden, James D. ;

Katz, Jason N. ;

Keeley, Ellen C. ;

Keller, Norma ;

Kontos, Michael C. ;

Lawler, Patrick R. ;

Menon, Venu ;

Metkus, Thomas S. ;

Miller, P. Elliott ;

Nativi-Nicolau, Jose ;

Newby, L. Kristin ;

Park, Jeong-Gun ;

Phreaner, Nicholas ;

Roswell, Robert O. ;

Schulman, Steven P. ;

Sinha, Shashank S. ;

Snell, R. Jeffrey ;

Solomon, Michael A. ;

Teuteberg, Jeffrey J. ;

Tymchak, Wayne ;

van Diepen, Sean ;

Morrow, David A. .

CIRCULATION-HEART FAILURE, 2019, 12 (11)

[6] Temporal trends in the epidemiology, management, and outcome of patients with cardiogenic shock complicating acute coronary syndromes [J].

De Luca, Leonardo ;

Olivari, Zoran ;

Farina, Andrea ;

Gonzini, Lucio ;

Lucci, Donata ;

Di Chiara, Antonio ;

Casella, Gianni ;

Chiarella, Francesco ;

Boccanelli, Alessandro ;

Di Pasquale, Giuseppe ;

De Servi, Stefano ;

Bovenzi, Francesco Maria ;

Gulizia, Michele Massimo ;

Savonitto, Stefano .

EUROPEAN JOURNAL OF HEART FAILURE, 2015, 17 (11) :1124-1132

[7] Cardiac power is the strongest hemodynamic correlate of mortality in cardiogenic shock: A report from the SHOCK trial registry [J].

Fincke, R ;

Hochman, JS ;

Lowe, AM ;

Menon, V ;

Slater, JN ;

Webb, JG ;

LeJemtel, TH ;

Cotter, G .

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2004, 44 (02) :340-348

[8] SHould we emergently revascularise occluded coronaries for cardiogenic shocK: An international randomized trial of emergency PTCA/CABG-trial design [J].

Hochman, JS ;

Sleeper, LA ;

Godfrey, E ;

McKinlay, SM ;

Sanborn, T ;

Col, J ;

LeJemtel, T .

AMERICAN HEART JOURNAL, 1999, 137 (02) :313-321

[9] Twenty-Year Trends in the Incidence and Outcome of Cardiogenic Shock in AMIS Plus Registry [J].

Hunziker, Lukas ;

Radovanovic, Dragana ;

Jeger, Raban ;

Pedrazzini, Giovanni ;

Cuculi, Florim ;

Urban, Philip ;

Erne, Paul ;

Rickli, Hans ;

Pilgrim, Thomas ;

Hess, F. ;

Simon, R. ;

Hangartner, P. J. ;

Hufschmid, U. ;

Hornig, B. ;

Altwegg, L. ;

Jeger, R. ;

Trummler, S. ;

Windecker, S. ;

Pilgrim, T. ;

Rueff, T. ;

Loretan, P. ;

Roethlisberger, C. ;

Evequoz, D. ;

Mang, G. ;

Ryser, D. ;

Muller, P. ;

Jecker, R. ;

Kistler, W. ;

Hongler, T. ;

Stauble, S. ;

Freiwald, G. ;

Schmid, H. P. ;

Stauffer, J. C. ;

Cook, S. ;

Bietenhard, K. ;

Roffi, M. ;

Wojtyna, W. ;

Schonenberger, R. ;

Simonin, C. ;

Waldburger, R. ;

Schmidli, M. ;

Federspiel, B. ;

Weiss, E. M. ;

Marty, H. ;

Weber, K. ;

Zender, H. ;

Poepping, I. ;

Hugi, A. ;

Koltai, E. ;

Iglesias, J. F. .

CIRCULATION-CARDIOVASCULAR INTERVENTIONS, 2019, 12 (04)

[10] Trends in Incidence, Management, and Outcomes of Cardiogenic Shock Complicating ST-Elevation Myocardial Infarction in the United States [J].

Kolte, Dhaval ;

Khera, Sahil ;

Aronow, Wilbert S. ;

Mujib, Marjan ;

Palaniswamy, Chandrasekar ;

Sule, Sachin ;

Jain, Diwakar ;

Gotsis, William ;

Ahmed, Ali ;

Frishman, William H. ;

Fonarow, Gregg C. .

JOURNAL OF THE AMERICAN HEART ASSOCIATION, 2014, 3 (01) :e000590

← 1 2 3 →