Complications from percutaneous-left ventricular assist devices versus intra-aortic balloon pump in acute myocardial infarction-cardiogenic shock

被引：17

作者：

Vallabhajosyula, Saraschandra ^{[1
,2
,3
,4
]}

Subramaniam, Anna, V ^{[5
]}

Murphree, Dennis H., Jr. ^{[6
]}

Patlolla, Sri Harsha ^{[7
]}

Ya'Qoub, Lina ^{[8
]}

Kumar, Vinayak ^{[5
]}

Verghese, Dhiran ^{[9
]}

Cheungpasitporn, Wisit ^{[10
]}

Jentzer, Jacob C. ^{[1
,2
]}

Sandhu, Gurpreet S. ^{[1
]}

Gulati, Rajiv ^{[1
]}

Shah, Nilay D. ^{[6
,11
]}

Gersh, Bernard J. ^{[1
]}

Holmes, David R., Jr. ^{[1
]}

Bell, Malcolm R. ^{[1
]}

Barsness, Gregory W. ^{[1
]}

机构：

[1] Mayo Clin, Dept Cardiovasc Med, Rochester, MN 55905 USA

[2] Mayo Clin, Div Pulm & Crit Care Med, Dept Med, Rochester, MN 55905 USA

[3] Mayo Clin, Ctr Clin & Translat Sci, Grad Sch Biomed Sci, Rochester, MN 55905 USA

[4] Emory Univ, Sch Med, Dept Med, Sect Intervent Cardiol,Div Cardiovasc Med, Atlanta, GA 30322 USA

[5] Mayo Clin, Dept Med, Rochester, MN USA

[6] Mayo Clin, Dept Hlth Sci Res, Rochester, MN USA

[7] Mayo Clin, Dept Cardiovasc Surg, Rochester, MN USA

[8] Louisiana State Univ, Sch Med, Dept Med, Div Cardiovasc Med, Shreveport, LA 71105 USA

[9] Amita Hlth St Joseph Hosp, Dept Med, Chicago, IL USA

[10] Univ Mississippi, Sch Med, Div Nephrol, Dept Med, Jackson, MS 39216 USA

[11] Mayo Clin, Robert D & Patricia E Kern Ctr Sci Healthcare Del, Rochester, MN USA

来源：

PLOS ONE | 2020年 / 15卷 / 08期

基金：

美国国家卫生研究院;

关键词：

RANDOMIZED CLINICAL-TRIAL; CORONARY INTERVENTION; HEMODYNAMIC SUPPORT; COUNTERPULSATION; METAANALYSIS; EFFICACY; SAFETY;

D O I：

10.1371/journal.pone.0238046

中图分类号：

O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];

学科分类号：

07 ; 0710 ; 09 ;

摘要：

Background There are limited data on the complications with a percutaneous left ventricular assist device (pLVAD) vs. intra-aortic balloon pump (IABP) in acute myocardial infarction-cardiogenic shock (AMI-CS). Objective To assess the trends, rates and predictors of complications. Methods Using a 17-year AMI-CS population from the National Inpatient Sample, AMI-CS admissions receiving pLVAD and IABP support were evaluated for vascular, lower limb amputation, hematologic, neurologic and acute kidney injury (AKI) complications. In-hospital mortality, hospitalization costs and length of stay in pLVAD and IABP cohorts with complications was studied. Results Of 168,645 admissions, 7,855 (4.7%) receiving pLVAD support. The pLVAD cohort had higher comorbidity, cardiac arrest (36.1% vs. 29.7%) and non-cardiac organ failure (74.7% vs. 56.9%) rates. Complications were higher in pLVAD compared to IABP cohort-overall 69.0% vs. 54.7%; vascular 3.8% vs. 2.1%; lower limb amputation 0.3% vs. 0.3%; hematologic 36.0% vs. 27.7%; neurologic 4.9% vs. 3.5% and AKI 55.4% vs. 39.1% (allp<0.001 except for amputation). Non-White race, higher comorbidity, organ failure, and extracorporeal membrane oxygen use were predictors of complications for both cohorts. The pLVAD cohort with complications had higher in-hospital mortality (45.5% vs. 33.1%; adjusted odds ratio 1.65 [95% confidence interval 1.55-1.75]), shorter duration of hospital stay, and higher hospitalization costs compared to the IABP cohort with complications (allp<0.001). These results were consistent in propensity-matched pairs. Conclusions AMI-CS admissions receiving pLVAD had higher rates of complications compared to the IABP, with worse in-hospital outcomes in the cohort with complications.

引用

页数：15

共 42 条

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