Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
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SHR Neuro Krebs Kardio Lipid Stoffw Microb
Prunea, DM; Bachl, E; Herold, L; Kanoun, Schnur, SS; Pätzold, S; Altmanninger-Sock, S; Sommer, GA; Glantschnig, T; Kolesnik, E; Wallner, M; Ablasser, K; Bugger, H; Buschmann, E; Praschk, A; Fruhwald, FM; Schmidt, A; von, Lewinski, D; Toth, GG.
Impact of the Timing of Mechanical Circulatory Support on the Outcomes in Myocardial Infarction-Related Cardiogenic Shock: Subanalysis of the PREPARE CS Registry.
J Clin Med. 2024; 13(6): 1552
Doi: 10.3390/jcm13061552
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- Führende Autor*innen der Med Uni Graz
- Prunea Dan-Mihai
- Toth-Gayor Gabor
- Co-Autor*innen der Med Uni Graz
- Ablasser Klemens
- Altmanninger-Sock Siegfried
- Bugger Heiko Matthias
- Buschmann Eva Elina
- Fruhwald Friedrich
- Glantschnig Theresa
- Herold Lukas
- Kanoun Schnur Sadeek Sidney
- Kolesnik Ewald
- Pätzold Sascha
- Praschk Andreas
- Schmidt Albrecht
- von Lewinski Dirk
- Wallner Markus
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- Abstract:
- (1) Background: Mechanical circulatory support (MCS) in myocardial infarction-associated cardiogenic shock is subject to debate. This analysis aims to elucidate the impact of MCS's timing on patient outcomes, based on data from the PREPARE CS registry. (2) Methods: The PREPARE CS prospective registry includes patients who experienced cardiogenic shock (SCAI classes C-E) and were subsequently referred for cardiac catheterization. Our present analysis included a subset of this registry, in whom MCS was used and who underwent coronary intervention due to myocardial infarction. Patients were categorized into an Upfront group and a Procedural group, depending on the timing of MCS's introduction in relation to their PCI. The endpoint was in-hospital mortality. (3) Results: In total, 71 patients were included. MCS was begun prior to PCI in 33 (46%) patients (Upfront), whereas 38 (54%) received MCS during or after the initiation of PCI (Procedural). The groups' baseline characteristics and hemodynamic parameters were comparable. The Upfront group had a higher utilization of the Impella® device compared to extracorporeal membrane oxygenation (67% vs. 33%), while the Procedural group exhibited a balanced use of both (50% vs. 50%). Most patients suffered from multi-vessel disease in both groups (82% vs. 84%, respectively; p = 0.99), and most patients required a complex PCI procedure; the latter was more prevalent in the Upfront group (94% vs. 71%, respectively; p = 0.02). Their rates of complete revascularization were comparable (52% vs. 34%, respectively; p = 0.16). Procedural CPR was significantly more frequent in the Procedural group (45% vs. 79%, p < 0.05); however, in-hospital mortality was similar (61% vs. 79%, respectively; p = 0.12). (4) Conclusions: The upfront implantation of MCS in myocardial infarction-associated CS did not provide an in-hospital survival benefit.
- Find related publications in this database (Keywords)
- cardiogenic shock
- mechanical circulatory support
- myocardial infarction
- mechanical circulatory support timing
- in-hospital mortality