Prognosis in patients with cardiogenic shock who received temporary mechanical circulatory support

Kondo, T. et al. (2023) Prognosis in patients with cardiogenic shock who received temporary mechanical circulatory support. JACC: Asia, 3(1), pp. 122-134. (doi: 10.1016/j.jacasi.2022.10.004) (PMID:36873766) (PMCID:PMC9982290)

Abstract

Background: Temporary mechanical circulatory support (MCS) is often used in patients with cardiogenic shock (CS), and the type of MCS may vary by cause of CS. Objectives: To describe the causes of CS in patients receiving temporary MCS, the types of MCS used, and associated mortality. Methods We used a nationwide Japanese database to identify patients receiving temporary MCS for CS between April 2012 and March 2020. Results: Of the 65,837 patients, the cause of CS was acute myocardial infarction (AMI) in 77.4%, heart failure (HF) in 10.9%, valvular disease in 2.7%, fulminant myocarditis (FM) in 2.5%, arrhythmia in 4.5%, and pulmonary embolism (PE) in 2.0% of cases. The most commonly used MCS was an intra-aortic balloon pump (IABP) alone in AMI (79.2%) and in HF (76.5%), extracorporeal membrane oxygenation (ECMO) with IABP in FM (56.2%) and arrhythmia (43.4%), and ECMO alone in PE (71.5%). Overall in-hospital mortality was 32.4%; 30.0% in AMI, 32.6% in HF, 33.1% in valvular disease, 34.2% in FM, 60.9% in arrhythmia, and 59.2% in PE. Overall, in-hospital mortality increased from 30.4% in 2012 to 34.1% in 2019. After adjustment, valvular disease, FM and PE had lower in-hospital mortality than AMI: odds ratio [95%CI] for valvular disease 0.56 [0.50-0.64]; FM 0.58 [0.52-0.66]; PE 0.49 [0.43-0.56], whereas HF had similar in-hospital mortality (0.99 [0.92-1.05]) and arrhythmia had higher in-hospital mortality (1.14 [1.04-1.26]). Conclusion: In a Japanese national registry of patients with CS, different causes of CS were associated with different types of MCS and differences in survival.

• Item Type: Articles
• Additional Information: This study was supported by grant from Fukuda Foundation for Medical Technology. J.M. and MCP are supported by a British Heart Foundation Centre of Research Excellence Grant RE/18/6/34217.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Butt, Mr Jawad and Kondo, Dr Toru and McMurray, Professor John and Petrie, Professor Mark
• Authors: Kondo, T., Araki, T., Imaizumi, T., Sumita, Y., Nakai, M., Tanaka, A., Okumura, T., Butt, J. H., Petrie, M. C., McMurray, J. J.V., and Murohara, T.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
• Journal Name: JACC: Asia
• Publisher: Elsevier
• ISSN: 2772-3747
• ISSN (Online): 2772-3747
• Published Online: 31 October 2022
• Copyright Holders: Copyright © 2022 The Authors
• First Published: First published in JACC: Asia 3(1): 122-134
• Publisher Policy: Reproduced under a Creative Commons License

Project Code	Award No	Project Name	Principal Investigator	Funder's Name	Funder Ref	Lead Dept
303944		BHF Centre of Excellence	Colin Berry	British Heart Foundation (BHF)	RE/18/6/34217	CAMS - Cardiovascular Science