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Updated: Aug 5, 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

Percutaneous left ventricular assist device in cardiogenic shock associated with and without acute myocardial

Roopeessh Vempati1, John Gallagher2, Haidar Hajeh3

  • 1Department of Internal Medicine, Trinity Health Oakland Hospital, Pontiac, MI, USA.

Expert Review of Medical Devices
|July 28, 2026
PubMed

Insights

Patients with cardiogenic shock (CS) due to acute myocardial infarction (AMI-CS) treated with percutaneous left ventricular assist devices (pLVAD) had higher mortality and heart failure exacerbations compared to non-AMI CS patients. These findings highlight key outcome differences in CS management.

Area of Science:

  • Cardiology
  • Mechanical Circulatory Support
  • Critical Care Medicine

Background:

  • Percutaneous left ventricular assist devices (pLVAD) are increasingly utilized for cardiogenic shock (CS).
  • Outcomes may vary between acute myocardial infarction-related CS (AMI-CS) and non-AMI CS due to distinct pathophysiologies.
  • Understanding these differences is crucial for optimizing patient care.

Purpose of the Study:

  • To compare outcomes of pLVAD use in patients with AMI-CS versus non-AMI CS.
  • To identify specific differences in mortality and morbidity between these two patient groups.
  • To inform clinical decision-making regarding mechanical circulatory support in CS.

Main Methods:

  • Utilized the USA TriNetX Network (2016-2024) to identify adult CS patients treated with pLVAD.
  • Defined AMI-CS by myocardial infarction within seven days of pLVAD implantation.
  • Excluded patients with recent coronary artery bypass graft (CABG) and used propensity matching to create balanced cohorts (n=2,026 each).

Main Results:

  • AMI-CS patients experienced higher 30-day (HR 1.19), 90-day (HR 1.13), and 180-day (HR 1.14) mortality compared to non-AMI CS.
  • Heart failure exacerbations (HR 1.21) and pulmonary edema (HR 1.23) were significantly more common in the AMI-CS group.
  • Rates of stroke, arrhythmias, cardiac arrest, acute kidney injury, bleeding, vascular complications, and hemodialysis were comparable between groups.

Conclusions:

  • Patients with AMI-CS treated with pLVAD demonstrate significantly higher mortality rates.
  • AMI-CS is associated with increased heart failure-related morbidity, including exacerbations and pulmonary edema.
  • These findings underscore the need for tailored management strategies for CS patients based on underlying etiology.
Abstract

Keywords:
Acute myocardial infarctioncardiogenic shockheart failureimpellamechanical circulatory supportmicroaxial flow pumpmortalitypercutaneous left ventricular assist device

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