Journal of cardiovascular development and disease
Von Mihali K, Kreutz J, Markus B und 7 weiteren.
Inhalt auf Englisch
(1)
The association between microaxial flow pump (mAFP) timing and outcomes in acute myocardial infarction-related cardiogenic shock (AMI-CS) remains uncertain. (2)
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We conducted a retrospective single-center study of patients with AMI-CS admitted between January 2017 and July 2025. Prespecified 24 h landmark analyses included patients alive 24 h after intensive care unit (ICU) admission. The primary analysis compared patients with ST-segment elevation myocardial infarction (STEMI) receiving mAFP within 6 h with STEMI patients managed without temporary mechanical circulatory support (tMCS). Later STEMI implantation (>6-≤24 h) and both non-ST-segment elevation myocardial infarction (NSTEMI) timing cohorts were exploratory. The primary endpoint was subsequent in-hospital mortality from the landmark onward. Associations were assessed using multivariable logistic regression and propensity score-weighted models. (3)
In the primary STEMI cohort, 106 patients received mAFP within 6 h and 59 received no-tMCS. Subsequeunt in-hospital mortality was 17.0% versus 23.7%, respectively (p = 0.293). Early mAFP implantation was associated with lower mortality in the fully adjusted model (OR, 0.25 [95% CI, 0.06-0.99]; p = 0.048). Propensity score-based estimates were directionally consistent, with significance in the doubly robust weighted model (OR, 0.22 [95% CI, 0.06-0.85]; p = 0.028) but not in all weighted models. Later-timing and NSTEMI estimates did not reach statistical significance and were imprecise. (4)
Among patients with STEMI who survived the first 24 h after ICU admission, mAFP implantation within 6 h was associated with lower subsequent in-hospital mortality. Exploratory later-timing and NSTEMI estimates were inconclusive. These observational findings are hypothesis-generating and require prospective validation.
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