{
    "abstract": "The role of acute mechanical circulatory support (aMCS) in patients with stress-induced cardiomyopathy (SIC) complicated by cardiogenic shock (CS) is not well studied. Here, we describe the incidence and outcomes of aMCS use in SIC-CS using a large national database.\nUsing the Nationwide Readmissions Database from January 2016 to November 2019, we identified patients hospitalized with SIC who received isolated intra-aortic balloon pump (IABP), microaxial flow pump (Impella, Abiomed), or extracorporeal membrane oxygenation (ECMO) during the index hospitalization.\nA total of 902 among 94,709 hospitalizations for SIC (1.0%) required aMCS during the index hospitalization: 611 had IABP (67.7%), 189 had Impella (21.0%) and 102 had ECMO (11.3%). Patients with ECMO or Impella had higher in-hospital mortality rates than those with IABP (37.3% vs 29.1% vs 18.5%, respectively). There was an increased adjusted risk of in-hospital death with Impella (adjusted odds ratio [aOR], 1.98; 95% CI, 1.12-3.49) and ECMO (aOR, 4.15; 95% CI, 1.85-9.32) vs IABP. Impella was associated with an increased adjusted risk of 30-day readmission compared to IABP (aOR, 2.53; 95% CI, 1.16-5.51). Patients with ECMO or Impella had a higher incidence of renal replacement therapy and vascular/bleeding complications compared to those who received IABP.\nIn this nationwide analysis using an administrative database, patients who received ECMO and Impella showed higher rates of in-hospital mortality, renal replacement therapy, and vascular/bleeding complications compared to those who received IABP. Patients with more comorbidities may receive more aggressive hemodynamic support which may account for observed mortality differences. Future prospective studies with objective and universal characterization of baseline clinical and hemodynamic characteristics of patients with CS secondary to SIC are needed.",
    "authors": [
        {
            "affiliation": "Section of Cardiovascular Medicine, Department of Medicine, Yale University School of Medicine, New Haven, Connecticut.",
            "firstname": "Sun-Joo",
            "initials": "SJ",
            "lastname": "Jang"
        },
        {
            "affiliation": "Department of Medicine, Yale New Haven Health, Bridgeport Hospital, Bridgeport, Connecticut.",
            "firstname": "Fabricio",
            "initials": "F",
            "lastname": "Malaguez Webber"
        },
        {
            "affiliation": "Department of Medicine, Yale New Haven Health, Bridgeport Hospital, Bridgeport, Connecticut.",
            "firstname": "Md Mashiul",
            "initials": "MM",
            "lastname": "Alam"
        },
        {
            "affiliation": "Division of Cardiology, Department of Medicine, Yale New Haven Health, Bridgeport Hospital, Bridgeport, Connecticut.",
            "firstname": "Ju Young",
            "initials": "JY",
            "lastname": "Bae"
        },
        {
            "affiliation": "Department of Medicine, Yale New Haven Health, Bridgeport Hospital, Bridgeport, Connecticut.",
            "firstname": "Abhinav",
            "initials": "A",
            "lastname": "Aggarwal"
        },
        {
            "affiliation": "Department of Medicine, Yale New Haven Health, Bridgeport Hospital, Bridgeport, Connecticut.",
            "firstname": "Alexander",
            "initials": "A",
            "lastname": "Thomas"
        },
        {
            "affiliation": "Division of Cardiology, Department of Medicine, Yale New Haven Health, Bridgeport Hospital, Bridgeport, Connecticut.",
            "firstname": "Stuart W",
            "initials": "SW",
            "lastname": "Zarich"
        },
        {
            "affiliation": "Section of Cardiovascular Medicine, Department of Medicine, Yale University School of Medicine, New Haven, Connecticut.",
            "firstname": "Tariq",
            "initials": "T",
            "lastname": "Ahmad"
        },
        {
            "affiliation": "Section of Cardiovascular Medicine, Department of Medicine, Yale University School of Medicine, New Haven, Connecticut.",
            "firstname": "P Elliott",
            "initials": "PE",
            "lastname": "Miller"
        },
        {
            "affiliation": "Section of Cardiovascular Medicine, Department of Medicine, Yale University School of Medicine, New Haven, Connecticut.",
            "firstname": "Carlos D",
            "initials": "CD",
            "lastname": "Davila"
        }
    ],
    "conclusions": null,
    "copyrights": "\u00a9 2023 The Author(s).",
    "doi": "10.1016/j.jscai.2023.101185\n10.1093/eurheartj/ehy076\n10.1056/NEJMoa1406761\n10.1002/ejhf.424\n10.1161/CIRCULATIONAHA.118.036164\n10.1016/j.ijcard.2020.05.033\n10.1056/NEJMoa043046\n10.1016/j.ijcard.2014.11.149\n10.15557/JoU.2014.0044\n10.1016/j.amjcard.2020.09.047\n10.1093/ehjopen/oead003\n10.1161/CIRCULATIONAHA.118.036614\n10.1002/ccd.29834\n10.1001/jamanetworkopen.2020.37748\n10.1016/j.jchf.2022.10.002\n10.1002/ccd.28329\n10.1016/j.jacc.2022.01.018\n10.1161/CIRCHEARTFAILURE.120.007099\n10.3389/fcvm.2021.563853\n10.1016/j.jchf.2020.08.012\n10.1161/CIRCULATIONAHA.106.612812\n10.1016/j.carrev.2019.05.001\n10.1016/j.jacc.2023.03.398\n10.1016/j.jcin.2018.10.046\n10.1002/ehf2.12546\n10.1016/j.jaccas.2019.06.022\n10.1002/ehf2.13117\n10.1016/j.ajpc.2023.100474\n10.1161/JAHA.119.015503\n10.3390/jcm10163701\n10.1016/j.ahj.2012.04.010",
    "journal": "Journal of the Society for Cardiovascular Angiography & Interventions",
    "keywords": [
        "cardiogenic shock",
        "interventional heart failure",
        "mechanical circulatory support",
        "stress-induced cardiomyopathy"
    ],
    "methods": null,
    "publication_date": "2024-08-12",
    "pubmed_id": "39131072\n29850871\n26332547\n26548803\n30586690\n32473281\n15703419\n25481310\n26674265\n33035466\n36789137\n30586755\n34156755\n33616664\n36342421\n31104355\n35115207\n32900234\n33644126\n33121702\n16908769\n31227392\n37197841\n30711550\n31898420\n34316775\n33244882\n36923367\n32468933\n34441995\n22877807",
    "results": "A total of 902 among 94,709 hospitalizations for SIC (1.0%) required aMCS during the index hospitalization: 611 had IABP (67.7%), 189 had Impella (21.0%) and 102 had ECMO (11.3%). Patients with ECMO or Impella had higher in-hospital mortality rates than those with IABP (37.3% vs 29.1% vs 18.5%, respectively). There was an increased adjusted risk of in-hospital death with Impella (adjusted odds ratio [aOR], 1.98; 95% CI, 1.12-3.49) and ECMO (aOR, 4.15; 95% CI, 1.85-9.32) vs IABP. Impella was associated with an increased adjusted risk of 30-day readmission compared to IABP (aOR, 2.53; 95% CI, 1.16-5.51). Patients with ECMO or Impella had a higher incidence of renal replacement therapy and vascular/bleeding complications compared to those who received IABP.",
    "title": "Early Clinical Outcomes of Patients With Stress-Induced Cardiomyopathy Receiving Acute Mechanical Support in the US.",
    "xml": "<Element 'PubmedArticle' at 0x788504707c90>"
}