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Updated: Jun 13, 2026
06:10
Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
Published on: June 12, 2021
Palliative and End-of-Life Care Utilization in Cardiogenic Shock Complicating Acute Myocardial Infarction: A
Lee H Sterling1, Shannon M Fernando2, Robert Talarico3
1Division of Critical Care Medicine, University of British Columbia, Vancouver, British Columbia, Canada; CAPITAL Research Group, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
JACC. Advances
|June 11, 2026
Summary
Early palliative care for survivors of acute myocardial infarction with cardiogenic shock (AMI-CS) is linked to better end-of-life outcomes. Involvement before the final weeks reduced hospital and ICU deaths, improving care for these patients.
Area of Science:
- Cardiology
- Palliative Care
- Health Services Research
Background:
- Limited understanding of end-of-life trajectories for acute myocardial infarction with cardiogenic shock (AMI-CS) survivors post-discharge.
- Uncertainty regarding palliative care utilization in AMI-CS survivors.
Purpose of the Study:
- To investigate long-term palliative and end-of-life care patterns in AMI-CS survivors.
- To assess the impact of palliative care timing on mortality outcomes.
Main Methods:
- Population-based retrospective cohort study in Ontario, Canada (2009-2020).
- Analysis of 3,881 AMI-CS survivors who died during longitudinal follow-up.
- Examination of palliative care utilization and place of death.
Main Results:
- Median survival was 1,096 days; 54.1% died in acute care.
- Palliative care was often initiated late (47.7% in the last 14 days).
- Earlier palliative care referrals were associated with reduced in-hospital (aOR 0.50) and ICU (aOR 0.34) deaths.
Conclusions:
- Early and intermediate palliative care involvement in AMI-CS survivors is associated with decreased in-hospital and ICU mortality.
- Palliative care consultation may significantly improve end-of-life outcomes for AMI-CS survivors.
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