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Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
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Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock

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Cardiogenic shock: incidence, survival and mechanical circulatory support usage 2007-2017-insights from a national

Corinna N Lang1,2, Klaus Kaier3, Viviane Zotzmann4,5

  • 1Heart Center Freiburg University, Department of Cardiology and Angiology I, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany. corinna.nadine.lang@uniklinik-freiburg.de.

Clinical Research in Cardiology : Official Journal of the German Cardiac Society
|December 1, 2020
PubMed

Insights

The incidence of cardiogenic shock (CS) is rising, yet survival rates remain low. Mechanical circulatory support (MCS) use in CS patients has decreased, with shifts in device types and varying survival outcomes.

Area of Science:

  • Cardiology
  • Intensive Care Medicine
  • Medical Technology

Background:

  • Cardiogenic shock (CS) management relies on mechanical circulatory support (MCS) to maintain cardiac output.
  • Understanding the trends in MCS utilization and outcomes for CS is crucial for clinical practice.

Purpose of the Study:

  • To quantify the incidence, outcomes, and influence of MCS in cardiogenic shock patients over a decade (2007-2017).

Main Methods:

  • Retrospective analysis of CS patients hospitalized in a German tertiary university hospital from 2007-2017.
  • Utilized ICD-10 code R57.0 for CS identification and German procedure codes (OPS) for MCS application.

Main Results:

  • CS incidence increased by 65.6% from 2007 to 2017, with overall hospital survival remaining low (around 40%).
  • MCS utilization in CS patients decreased from 16.0% in 2007 to 13.9% in 2017.
  • Significant survival differences observed among MCS devices: Intra-aortic balloon pump (IABP) showed higher survival (49.5%) compared to percutaneous ventricular assist devices (pVAD) (36.2%) and extracorporeal membrane oxygenation (VA-ECMO) (30.5%).

Conclusions:

  • Despite rising CS incidence, hospital survival rates are stagnant.
  • MCS use in CS patients has declined, with evolving device preferences.
  • Device-specific survival rates vary significantly, highlighting the need for careful selection of MCS in CS management.
Abstract

Keywords:
Cardiogenic shockECMOMechanical circulatory supportpVAD

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