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Updated: Jun 19, 2025
Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
Published on: June 12, 2021
Resource Utilization and Costs Associated With Cardiogenic Shock Complicating Myocardial Infarction: A
Simon Parlow1,2, Shannon M Fernando1,2,3,4, Michael Pugliese4,5
1CAPITAL Research Group, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
Insights
Cardiogenic shock due to acute myocardial infarction (AMI-CS) incurs substantial healthcare costs, with one-year expenses averaging $37,913 per patient. Future treatments should focus on reducing disability to improve cost-effectiveness.
Area of Science:
- Cardiology
- Health Economics
Background:
- Cardiogenic shock due to acute myocardial infarction (AMI-CS) is a severe condition with high morbidity and mortality.
- Associated healthcare costs and resource utilization for AMI-CS remain largely unquantified.
Purpose of the Study:
- To evaluate the healthcare costs and resource use associated with AMI-CS.
- Utilize administrative data from Ontario, Canada for comprehensive cost analysis.
Main Methods:
- Retrospective cohort study of adult AMI-CS patients from April 2009 to March 2019.
- Analysis of one-year costs post-index admission, including inpatient and post-discharge expenses.
- Generalized linear models identified factors associated with increased costs; stratification by revascularization strategy compared group costs.
Main Results:
- Included 9,789 patients; in-hospital mortality was 30.2%, 2-year mortality was 45.9%.
- Median total one-year cost was $37,913 (IQR: $20,113-$66,582).
- Patients surviving to discharge had significantly higher one-year costs ($45,713) compared to those who died in-hospital ($17,730). Coronary artery bypass grafting patients incurred the highest costs.
Conclusions:
- AMI-CS is linked to significant healthcare expenditures during hospitalization and post-discharge.
- Cost-effectiveness of future therapies could be enhanced by focusing on disability reduction alongside mortality improvement.
Background:
Cardiogenic shock due to acute myocardial infarction (AMI-CS) is associated with significant short- and long-term morbidity and mortality. Despite this, little is known about associated cost.
Objectives:
The purpose of this study was to evaluate the health care costs and resource use associated with AMI-CS using administrative data from the province of Ontario, Canada.
Methods:
This was a retrospective cohort study of adult patients with AMI-CS from April 2009 to March 2019. One-year costs following index admission were reported at an individual level. We used generalized linear models to identify factors associated with increased cost. We stratified patients by revascularization strategy to compare cost in each group and examined total cost at a patient level per individual fiscal year.
Results:
We included 9,789 consecutive patients with AMI-CS across 135 centers in Ontario (mean age 70.5 years; 67.7% male). Mortality in-hospital was 30.2%, and mortality at 2 years was 45.9%. The median inpatient cost per patient was $23,912 (IQR: $12,234-$41,833) with a median total 1-year cost of $37,913 (IQR: $20,113-$66,582). The median 1-year cost was $17,730 (IQR: $9,323-$38,379) for those who died in hospital, and $45,713 (IQR: $29,688-$77,683) for those surviving to discharge, with $12,719 (IQR: $4,262-$35,275) occurring after discharge. Patients who received coronary artery bypass grafting incurred the highest cost among revascularization groups. No significant differences were observed in cost per fiscal year from 2009 to 2019.
Conclusions:
AMI-CS is associated with significant health care costs, both during the index hospitalization and following discharge. To optimize cost-effectiveness, future therapies should aim to reduce disability in addition to improving mortality.
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