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Updated: Aug 6, 2026

Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
06:10

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

Published on: June 12, 2021

Risk, Management, and Outcomes in PCI-Treated Acute Coronary Syndrome With Cardiogenic Shock

Takanori Ohata1, Shun Kohsaka1, Ryo Nakamaru2

  • 1Department of Cardiology, Keio University School of Medicine, Tokyo, Japan.

JACC. Advances
|July 23, 2026
PubMed

Insights

Despite changes in mechanical circulatory support use for acute coronary syndrome with cardiogenic shock (ACS-CS) patients undergoing percutaneous coronary intervention (PCI), in-hospital mortality remains high. This highlights persistent challenges in managing this high-risk population.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Critical Care Cardiology

Background:

  • Acute coronary syndrome complicated by cardiogenic shock (ACS-CS) carries a high mortality rate.
  • Despite advancements in percutaneous coronary intervention (PCI) and mechanical circulatory support (MCS), outcomes remain poor.

Purpose of the Study:

  • To analyze temporal trends in patient risk profiles, treatment strategies, and in-hospital outcomes for ACS-CS patients undergoing PCI.
  • To assess changes in management and their impact on mortality over a decade.

Main Methods:

  • Analysis of 870 ACS-CS cases from a 24,527-patient PCI registry (2009-2019).
  • Patients categorized into four time periods to evaluate temporal changes.
  • Risk profiles assessed using National Cardiovascular Data Registry (NCDR) scores; trends in MCS use and mortality analyzed.

Main Results:

  • Predicted mortality and bleeding risk remained stable over the decade.
  • Overall MCS use decreased, mainly due to reduced intra-aortic balloon pump utilization.
  • Crude and risk-adjusted in-hospital mortality remained persistently high at approximately 30%.

Conclusions:

  • Management strategies for ACS-CS patients undergoing PCI evolved, particularly MCS use.
  • No significant improvement in in-hospital mortality was observed over the study period.
  • This underscores the persistent clinical challenges in treating high-risk ACS-CS patients.
Abstract

Keywords:
acute coronary syndromecardiogenic shockpercutaneous coronary intervention

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