The Differences In The Inpatient Outcomes And Utilization Of Temporary Mechanical Support In Cardiogenic Shock Patients With Anterior And Inferior Wall Myocardial Infarction: A Retrospective Analysis

Document Type

Conference Proceeding

Publication Date

1-1-2026

Publication Title

J Card Fail

Abstract

Introduction: Cardiogenic shock (CS) is a critical complication of acute myocardial infarction (MI), contributing significantly to morbidity and mortality despite advances in revascularization and supportive therapies. MIs are classified based on anatomical location, anterior wall MI, typically caused by ischemia in the left anterior descending artery (LAD), and inferior wall MI, usually due to occlusion of the right coronary artery. Mechanical circulatory support (MCS), such as intra-aortic balloon pumps (IABP), percutaneous left ventricular assist devices (pLVAD), and extracorporeal membrane oxygenation (ECMO), is essential for stabilizing hemodynamics and enhancing cardiac function in CS patients. However, research comparing outcomes and management strategies for anterior versus inferior STEMI in CS remains limited. Methods: We conducted a retrospective analysis using the National Inpatient Sample databases from January 2016 to December 2020. We identified all patients aged ≥18 years who were admitted with cardiogenic shock, and then further identified patients with concomitant diagnoses of anterior and inferior STEMI. We compared the rates of MCS utilization and inpatient outcomes between these patient groups. Results: A total of 96,515 admissions for cardiogenic shock related to anterior and inferior myocardial infarctions were analyzed. Over the period there was a slight increase in the incidence of both Anterior and inferior STEMI as indicated by the trend lines in Figure 1. The use of mechanical circulatory support (MCS) in CS patients with inferior STEMI was lower than in those with anterior STEMI (42.5% vs. 60.5%; adjusted odds ratio [aOR] 0.51, p < 0.001) (Figure 1). After adjusting for demographics and comorbidities, the anterior STEMI group exhibited a higher inpatient death rate compared to the inferior STEMI group (31.6% vs 29.9%, p<0.0114). There was also a higher incidence of acute kidney injury (AKI) (5.9% vs. 4.3%, p<0.0001) and lower discharge to home in the anterior STEMI group compared to the inferior STEMI group (36.9% vs 31.6%, p<0.0001). Conclusion: In conclusion, our study reveals that the utilization of MCS in the contemporary era is lower in patients with inferior MI compared to those with anterior MI. Additionally, patients with anterior MI who develop CS face higher mortality rates compared to those with inferior MI. These findings underscore the importance of considering the specific characteristics and management strategies for different types of STEMI-related CS.

Volume

32

Issue

1

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