TCT-276 Impact of Door to Support Time on Patients with ST-segment Elevation Myocardial Infarction and Cardiogenic Shock

Document Type

Conference Proceeding

Publication Date

10-28-2025

Publication Title

J Am Coll Cardiol

Abstract

Background: Use of mechanical circulatory support (MCS) devices has been shown to improve outcomes in patients with ST-segment elevation myocardial infarction and cardiogenic shock (STEMI-CS). We aimed to assess the relationship between door to support (DTS) time and short- and long-term outcomes in these patients. Methods: We combined data from RECOVER III (NCT04136392) and the National Cardiogenic Shock Initiative (NCT03677180), which were single-arm, multicenter studies enrolling patients who underwent revascularization with Impella for STEMI-CS. We compared outcomes of patients based on quartiles (Q) of DTS times. Results: Between 2016 and 2020, 505 patients with STEMI-CS were enrolled across 116 US centers. Median DTS time per quartile was 52, 77, 112, and 217 minutes in Q1 to Q4, respectively. Baseline demographics were similar across DTS quartiles, except there were fewer women in Q1. Patients in Q1 were more likely to present in shock on admission (80.2 vs. 67.4%; p=0.01), have higher pulmonary capillary wedge pressure (30.0 vs. 24.8 mmHg; p=0.02), and have TIMI 0 flow in the infarct-related artery (81.7 vs. 70.9%; p=0.02), compared to patients in Q2-Q4. Patients with shorter DTS time (Q1) had improved survival at 1-year compared to those with longer DTS time (Q2-Q4) (52.8% vs. 39.4%; p<0.02) (Figure). [Formula presented] Conclusion: In a cohort of patients treated early with PCI and Impella, a shorter DTS time (<60 minutes) appeared to be associated with lower 1-year mortality. Larger studies are needed to verify these findings. Categories: CORONARY: Hemodynamic Support, Cardiogenic Shock and Cardiac Arrest

Volume

86

Issue

17

First Page

B122

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