Contemporary Trends and Predictors of Utilization of Percutaneous Ventricular Assist Devices in ST Elevation Myocardial Infarction Complicated by Cardiogenic Shock

Abstract

Introduction Recent innovations have led to the use of percutaneous ventricular assist devices (pVADs) in patients presenting with ST- elevation myocardial infarction (STEMI) complicated by cardiogenic shocks (CS). The purpose of this study was to look at recent trends and predictors of utilization of pVADS in patients with STEMI-CS Methods Data from national inpatient from the year 2008 to 2017 was used for temporal trends. International Classification of Diseases (ICD)-9 and ICD-10 codes were used to identify patients of STEMI with CS. Pearson Chi-square was used for categorical variables for statistical analysis. Linear regression was used for trend analysis. Stepwise forward entry Logistic regression with analysis was used for predictors of utilization of pVADs (with entry of p 0.1). Standard Elixhauser comorbidities were used. Results 258,749 patients were identified. The median age was 67 (IQR, 58-77) years. Mortality was very high at 37.5% (97061). 52.0% (134,640) patients underwent Percutaneous intervention (PCI). 4.7% (12,098) percutaneous Ventricular assist devices (pVADs) used. This has increased over the years from 0.4%(100) in 2008 to 12.4% (3,510) in 2017 [p Conclusion Use of pVADs has increased over the years in patients with STEMI-CS over the years.