Ventricular Assist Device in Acute Myocardial Infarction

Area of Science:

• Cardiology
• Mechanical Circulatory Support
• Acute Myocardial Infarction

Background:

• Patients with acute myocardial infarction (AMI) experiencing acute heart failure or cardiogenic shock face high mortality with standard treatments.
• This highlights the need for advanced therapeutic strategies in this critical patient group.

Purpose of the Study:

• To evaluate the outcomes of patients with AMI who were treated with durable ventricular assist devices (VAD).
• To compare the VAD outcomes in AMI patients with those in non-AMI patient populations.

Main Methods:

• Utilized data from the INTERMACS registry, including patients who received VAD implantation for AMI.
• Compared outcomes between patients with AMI and those with non-AMI indications for VAD.

Main Results:

• VADs were implanted in 502 AMI patients, with 66% presenting as INTERMACS profile 1 (critically ill).
• AMI patients showed higher rates of pre-operative support (IABP, ECMO, intubation, cardiac arrest) compared to non-AMI patients.
• One-year survival with VAD support was 52% for AMI patients, with a lower adjusted late mortality hazard (HR: 0.55; p=0.02) compared to non-AMI patients.

Conclusions:

• Ventricular assist device (VAD) therapy is a viable and effective strategy for patients with AMI and acute heart failure or cardiogenic shock unresponsive to medical therapy.
• Outcomes for AMI patients receiving VADs are similar to other VAD populations, even though they are more critically ill at the time of implantation.