Prognostic Factors Among Patients Receiving Microaxial Flow Pump for Acute Myocardial Infarction-Related Cardiogenic...

Area of Science:

• Cardiology
• Critical Care Medicine
• Medical Devices

Background:

• Acute myocardial infarction-related cardiogenic shock (AMI-CS) is a severe complication with high mortality.
• Microaxial flow pump (mAFP) therapy is utilized for AMI-CS, but prognostic factors for short-term outcomes require further elucidation.

Purpose of the Study:

• To identify and analyze factors associated with short-term mortality in patients with AMI-CS undergoing mAFP therapy.
• To provide evidence-based insights for clinicians managing these high-risk patients.

Main Methods:

• A systematic literature search was conducted across four major databases (MEDLINE, Embase, CENTRAL, Scopus) from 2004 to 2025.
• Included were English-language studies of adult AMI-CS patients receiving mAFP, excluding those on concurrent ECMO or with out-of-hospital cardiac arrest.
• Meta-analyses of adjusted odds ratios were performed for factors identified in at least two studies, with risk of bias and certainty of evidence assessed.

Main Results:

• The analysis included 18 studies with 20,617 patients, showing a median short-term mortality of 50.7%.
• High-certainty evidence linked increased age, female sex, higher BMI, elevated heart rate, higher serum creatinine, mechanical ventilation, vasopressor use, ST-elevation myocardial infarction, cardiac arrest, and hypoxic-ischemic brain injury to increased short-term mortality.
• Specific adjusted odds ratios were reported for each identified factor.

Conclusions:

• Several prognostic factors significantly influence short-term mortality in AMI-CS patients treated with mAFP.
• These findings can inform clinical practice, patient selection, and family discussions regarding mAFP therapy in AMI-CS.