TCT-270 Contemporary Use of Mechanical Circulatory Support for the Treatment of Acute Myocardial Infarction Cardiogenic Shock (AMI-CS): Insights From the BMC2 Registry
Recommended Citation
Cantey E, Seth M, Wanamaker B, Daher E, Basir MB, Kaki A, Madder R, Sukul D, Gurm H. TCT-270 Contemporary Use of Mechanical Circulatory Support for the Treatment of Acute Myocardial Infarction Cardiogenic Shock (AMI-CS): Insights From the BMC2 Registry. J Am Coll Cardiol 2024; 84(18):B53.
Document Type
Conference Proceeding
Publication Date
10-29-2024
Publication Title
J Am Coll Cardiol
Abstract
Background: Recent randomized controlled trial evidence suggest a mortality benefit of microaxial flow pump (mAFP) in AMI-CS. We investigated the contemporary prevalence of MCS use in the treatment of AMI-CS in Michigan. Methods: We included all primary PCIs for STEMI complicated by CS performed at 48 Michigan hospitals between April 1, 2018, and December 31, 2023. We excluded patients with persistent neurologic deficit after cardiac arrest (CA) and the use of right ventricular MCS. The analysis cohort was divided into 4 groups: no-MCS, mAFP, IABP, and other MCS. Site-specific utilization of MCS was compared between the 4 groups. Results: AMI-CS was present in 9.3% (n = 1,989) of STEMIs; 38.3% were excluded from the analysis due to neurological injury post-CA. Of the study cohort, 52.4% of patients with AMI-CS were treated without MCS, 23.1% with IABP, 23.0% with mAFP, and 1.5% with other MCS devices. There was significant heterogeneity in the baseline comorbidities, procedural characteristics, and outcomes across MCS groups. Over the study period, each individual site treated a median of 17 patients (Q1, Q3: 12.3-34.8 patients) with AMI-CS with a median usage of mAFP of 21.6% (Q1, Q3: 10.1%, 33.3%). AMI-CS volume did not correlate with mAFP utilization (Pearson rho 0.092; P = 0.5) (Figure 1). [Formula presented] Conclusion: Hospitals in Michigan have low annual case volumes and significant heterogeneity in the treatment of AMI-CS. Future efforts are needed to enhance early recognition of AMI-CS, implement protocol-based care to optimize evidence-based use of mAFP, and streamline “hub and spoke models” to facilitate delivery of contemporary AMI-CS therapies including mAFP. Categories: CORONARY: Hemodynamic Support, Cardiogenic Shock and Cardiac Arrest.
Volume
84
Issue
18
First Page
B53
