Percutaneous left ventricular assist device in cardiogenic shock associated with and without acute myocardial infarction: a real-world retrospective cohort study.

Roopeessh Vempati; John Gallagher; Haidar Hajeh; Khaled Elnaggar; Ali Awad; Prakash Gupta; Joud Fahed; Muhammad Burhan; M Chadi Alraies

doi:10.1080/17434440.2026.2710388

PubMed · 42520850

Percutaneous left ventricular assist device in cardiogenic shock associated with and without acute myocardial infarction: a real-world retrospective cohort study.

Roopeessh Vempati·John Gallagher·Haidar Hajeh·Khaled Elnaggar·Ali Awad·Prakash Gupta·Joud Fahed·Muhammad Burhan·M Chadi Alraies

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Abstract

BACKGROUND: Percutaneous left ventricular assist devices (pLVAD, such as Impella), are increasingly used for cardiogenic shock (CS). Outcomes may differ between acute myocardial infarction-related CS (AMI-CS) and non-AMI CS due to differing pathophysiology and trajectories. METHODS: Using the USA TriNetX Network (2016-2024), we identified adults with CS treated withpLVAD. AMI-CS was defined by MI within seven days of implantation; non-AMI CS included all patients with CS not attributable to acute MI, representing heterogeneous etiologies such as decompensated cardiomyopathy, myocarditis, valvular failure, pulmonary vascular causes, and arrhythmic shock. Patients with recent coronary artery bypass graft (CABG) were excluded. Propensity matching produced two balanced cohorts (n = 2,026 each). RESULTS: Among 6,873 AMI-CS and 4,521 non-AMI CS patients, matched groups were similar (mean age 63 years, 26% female). AMI-CS had higher mortality at 30 days (hazard ratio [HR] 1.19, p = 0.002), 90 days (HR 1.13, p = 0.02), and 180 days (HR 1.14, p = 0.007). Heart failure (HF) exacerbations (HR 1.21, p < 0.001) and pulmonary edema (HR 1.23, p = 0.005) were also more common in AMI-CS. Stroke, ventricular arrhythmias, cardiac arrest, acute kidney injury, major bleeding, vascular complications, and hemodialysis were comparable. CONCLUSION: AMI-CS patients supported with pLVAD experienced higher mortality and greater HF-related morbidity than non-AMI CS.

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Humans Heart-Assist Devices Shock, Cardiogenic Female Myocardial Infarction Male Retrospective Studies Middle Aged Aged Treatment Outcome Acute myocardial infarction cardiogenic shock heart failure impella mechanical circulatory support microaxial flow pump mortality percutaneous left ventricular assist device Journal Article

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Roopeessh Vempati, John Gallagher, Haidar Hajeh, Khaled Elnaggar, Ali Awad, Prakash Gupta, Joud Fahed, Muhammad Burhan, M Chadi Alraies. 2026-07-29. Percutaneous left ventricular assist device in cardiogenic shock associated with and without acute myocardial infarction: a real-world retrospective cohort study.. https://doi.org/10.1080/17434440.2026.2710388

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Journal Article resource Aged subject Female subject Heart Failure subject Heart-Assist Devices subject Humans subject Journal Article subject Male subject Middle Aged subject Mortality subject Myocardial Infarction subject

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