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Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
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Antimicrobial Use in Acute Myocardial Infarction-Related Cardiogenic Shock.

Abduljabar Adi1,2, Rohit Jain1,2, Satvinder Guru1,2

  • 1Northwell Health New Hyde Park NY USA.

Journal of the American Heart Association
|March 29, 2026
PubMed
Summary
This summary is machine-generated.

Antimicrobial use is common in acute myocardial infarction cardiogenic shock, often broad-spectrum despite low infection rates. Stewardship is needed to optimize antimicrobial therapy in these patients.

Keywords:
acute myocardial infarctionantimicrobial stewardshipcardiogenic shocksepsissystemic inflammatory response syndrome

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Area of Science:

  • Cardiology
  • Infectious Diseases
  • Pharmacology

Background:

  • Antimicrobial use is frequent in acute myocardial infarction-related cardiogenic shock.
  • Data on prevalence, drivers, and outcomes of antimicrobial use are limited.

Purpose of the Study:

  • To describe the prevalence, patterns, and outcomes of antimicrobial use in patients with acute myocardial infarction-related cardiogenic shock.
  • To identify factors influencing antimicrobial prescribing and patient outcomes.

Main Methods:

  • Analysis of 1095 patients from the Northwell-Shock Registry (2016-2022).
  • Antimicrobial use defined as ≥24 hours of continuous therapy.
  • Comparison of clinical features and outcomes between antimicrobial use positive (AMU+) and negative (AMU-) groups.

Main Results:

  • Antimicrobials were used in 55% of patients, often initiated within 48 hours.
  • Low microbial culture positivity (12.6% blood, 20.4% urine) and rare resistant organisms (9.5% of positive blood cultures).
  • Prolonged antimicrobial use occurred in 70% despite negative cultures; broad-spectrum agents were common (84.9%).
  • Longer length of stay in AMU+ group (11 vs. 4 days), but similar mortality rates (35.2% vs. 37.2%).

Conclusions:

  • Over half of patients received antimicrobials, frequently broad-spectrum, despite low evidence of infection.
  • Findings suggest suboptimal antimicrobial prescribing in this population.
  • Targeted antimicrobial stewardship strategies are necessary to optimize use in acute myocardial infarction-related cardiogenic shock.