Author + information
Currently there is no consensus on ability of short term circulatory support to improve mortality in ST elevation myocardial infarction(STEMI) complicated by cardiogenic shock(CS). We attempted to evaluate the hypothesis that the use of short term circulatory support decreases length of stay.
In this serial cross-sectional study, we analyzed all adult patients with STEMI CS in the United States from 2010 to 2014 by using the National Inpatient Sample from the Healthcare Cost and Utilization Project. Data was extrapolated for mortality, circulatory support and length of stay. Cochrane armitage test was used for trend analysis.
In-hospital mortality in STEMI CS increased from 30.1% in 2010 to 32.4% in 2014(p<0.001).There was a significant increase in the use of percutaneous left ventricular assist device(PLVAD) and extra corporeal membrane oxygenation(ECMO) with minimal change in short term surgical support device(STS) use. Overall the length of stay after admission of patients who died did not change. A decrease in length of stay of patients who survived was observed.
Current management options have not decreased the incidence and progression of death in patients with STEMI CS. The advent of support has allowed for an earlier discharge in those who survive.
CORONARY: Hemodynamic Support and Cardiogenic Shock