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Updated: Feb 16, 2026
Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
Published on: June 12, 2021
Gender difference with the use of percutaneous left ventricular assist device in patients undergoing complex
Rajkumar Doshi1, Avneet Singh1, Rajiv Jauhar1
1Department of Cardiology, North Shore University Hospital, Northwell Health, Zucker School of Medicine at Hofstra/Northwell, Manhasset, USA.
Insights
This study found no gender differences in outcomes for complex high-risk patients treated with percutaneous left ventricular assist devices. While males experienced more secondary complications, in-hospital mortality and 30-day survival were similar between genders.
Area of Science:
- Cardiology
- Interventional Cardiology
- Medical Device Technology
Background:
- Complex high-risk indicated patients often face challenging interventional treatments with poor outcomes.
- Percutaneous left ventricular assist devices (pLVADs) are increasingly used for hemodynamic support in these patients.
- Limited data exists on gender-specific outcomes for pLVAD use in complex high-risk patients.
Purpose of the Study:
- To compare in-hospital and short-term outcomes between males and females undergoing pLVAD implantation.
- To evaluate the safety and efficacy of pLVADs across different genders in a complex patient population.
Main Methods:
- A retrospective analysis of 160 complex high-risk indicated patients (132 male, 28 female) not in cardiogenic shock.
- Inclusion criteria: ejection fraction <35% with additional risk factors (atherectomy, unprotected left main, or multi-vessel disease).
- Impella 2.5 or Impella CP devices were used for left ventricular support.
Main Results:
- Propensity score matched analysis showed no significant difference in in-hospital mortality between genders (8.3% vs. 12.5%, p=0.54).
- Males had higher rates of secondary outcomes including myocardial infarction, cardiogenic shock, heart failure, and major adverse cardiac events.
- 30-day survival rates were similar for both males and females (88.9% vs. 87.5%, p=0.31).
Conclusions:
- Percutaneous left ventricular assist device support shows no gender-based differences in clinical outcomes for complex high-risk patients.
- Males experienced higher rates of secondary complications, but in-hospital mortality and 30-day survival were comparable.
- Incomplete revascularization was associated with worse outcomes in both genders.
Background:
The interventional treatment of complex high-risk indicated patients is technically difficult and can result in poor outcomes. Thus, percutaneous left ventricular assist devices are being increasingly used to provide hemodynamic support. No data is available comparing male and female for Complex High-risk Indicated Patients treated with percutaneous left ventricular assist devices. Our goal was to evaluate in-hospital as well as short term outcomes comparing males and females.
Methods:
There were 160 complex high-risk indicated patients with percutaneous left ventricular assist device use who were not in cardiogenic shock. A total of 132 male and 28 female patients were included. Ejection fraction below 35% with one additional criterion such as use of atherectomy device or treatment on unprotected left main disease or multi-vessel disease were our inclusion criteria. An Impella 2.5 or Impella CP (Abiomed Inc.) device was used as a left ventricular support device.
Results:
There was no difference in in-hospital mortality between the genders after performing a propensity score matched analysis (8.3% vs. 12.5%, p=0.54). Secondary outcomes of myocardial infarction, cardiogenic shock, congestive heart failure, dysrhythmia, major adverse cardiac events and composite of all complications were higher in males. Furthermore, 30-day survival was similar in males and females (88.9% vs. 87.5%, p=0.31). In addition, worse complications rates and survival were noted in patients with incomplete revascularization compared with those patients with complete revascularization in both gender.
Conclusion:
This study demonstrated no gender difference in clinical outcomes when using percutaneous left ventricular assist device support for the treatment of complex high-risk indicated patients. Overall, males had higher secondary outcomes compared with females with no difference in in-hospital mortality or 30-day survival rates.
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