Outcomes with mechanical circulatory support devices among patients with mechanical complications of acute myocardial infarction.

IF 4.6 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

European Heart Journal: Acute Cardiovascular Care Pub Date : 2025-05-16 DOI:10.1093/ehjacc/zuaf039

Ahmed M Younes, Ahmed K Mahmoud, Ibrahim Kamel, Linus Williams, Ahmed Maraey, Mahmoud Khalil, Ahmed Elzanaty, Rodrigo Bagur, Abdulla A Damluji, Jacqueline E Tamis-Holland, Islam Y Elgendy

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引用次数: 0

Abstract

Aims: The aim of this study is to examine the trends and outcomes of mechanical circulatory support (MCS) device use among patients with mechanical complications of acute myocardial infarction (AMI).

Methods and results: Using data from the National Inpatient Sample (a large admirative database in the USA) years 2016-20, we identified AMI admissions (ST-elevation and non-ST-elevation myocardial infarction) with mechanical complications (ventricular septal defect, free wall rupture, or papillary muscle rupture). Among 4 450 219 AMI patients, 7025 (0.2%) had a mechanical complication of which 3115 patients (44.3%) received at least one MCS device. There was a rising trend in MCS use (39.3% in 2016 to 48.9% in 2020, Ptrend = 0.02), but there was no corresponding reduction in the incidence of in-hospital mortality (36.9% in 2016 vs. 43.4% in 2020, Ptrend = 0.75). There was no significant difference in in-hospital mortality between those who received MCS vs. those who did not (48.4 vs. 34.5%, respectively).

Conclusion: In this large observational analysis of AMI hospitalizations, mechanical complications were rare and associated with very high in-hospital mortality. Although the use of MCS has increased, in-hospital mortality rates remain high even among patients who received MCS. Further investigations are needed to clarify the role of MCS devices among patients with mechanical complications of AMI.

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机械循环支持装置在急性心肌梗死机械并发症患者中的应用效果。

背景：急性心肌梗死（AMI）的机械并发症是罕见的，但与相当高的死亡率相关。虽然指南建议机械循环支持（MCS）装置作为最终治疗的潜在桥梁，但支持这一建议的研究有限。方法：使用来自2016-2020年美国国家住院患者样本（一个大型钦佩数据库）的数据，我们确定了AMI入院患者（st段抬高和非st段抬高心肌梗死）伴有机械并发症（室间隔缺损、游离壁破裂或乳头肌破裂）。使用调整潜在混杂因素的Logistic回归模型来评估MCS使用的时间趋势，并比较接受MCS与未接受MCS的住院死亡率。结果：在4,450,219例AMI患者中，7,025例（0.2%）患者出现机械并发症，其中3,115例（44.3%）患者接受了至少一个MCS装置。MCS的使用率呈上升趋势（2016年为39.3%，2020年为48.9%，p趋势=0.02），但院内死亡率没有相应下降（2016年为36.9%，2020年为43.4%，p趋势=0.75）。接受MCS组与未接受MCS组的住院死亡率无显著差异（分别为48.4%和34.5%）。结论：在这项关于AMI住院的大型观察性分析中，机械性并发症非常罕见，且与非常高的住院死亡率相关。然而，尽管MCS的使用有所增加，但即使在接受MCS的患者中，住院死亡率仍然很高。需要进一步的研究来阐明MCS装置在AMI机械并发症患者中的作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Heart Journal: Acute Cardiovascular Care Medicine-General Medicine

CiteScore

8.50

自引率

4.90%

发文量

325

期刊介绍： The European Heart Journal - Acute Cardiovascular Care (EHJ-ACVC) offers a unique integrative approach by combining the expertise of the different sub specialties of cardiology, emergency and intensive care medicine in the management of patients with acute cardiovascular syndromes. Reading through the journal, cardiologists and all other healthcare professionals can access continuous updates that may help them to improve the quality of care and the outcome for patients with acute cardiovascular diseases.