{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T21:32:30Z","timestamp":1769635950566,"version":"3.49.0"},"reference-count":48,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,5,30]],"date-time":"2020-05-30T00:00:00Z","timestamp":1590796800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100005440","name":"Center for Scientific Review","doi-asserted-by":"publisher","award":["Funding from NIH 1R01HL139785\u201001 to Dr. Navin K Ka"],"award-info":[{"award-number":["Funding from NIH 1R01HL139785\u201001 to Dr. Navin K Ka"]}],"id":[{"id":"10.13039\/100005440","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Bleeding complications and acute limb ischemia (ALI) are devastating vascular complications in patients with ST\u2010segment elevation myocardial infarction (STEMI). Cardiogenic shock (CS) can further increase this risk due to multiorgan failure. In the contemporary era, percutaneous mechanical circulatory support is commonly used for management of CS. We hypothesized that vascular complications may be an important determinant of clinical outcomes for CS due to STEMI (CS\u2010STEMI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>We evaluated 10\u2010year national trends, resource utilization and outcomes of bleeding complications, and ALI in CS\u2010STEMI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a retrospective cohort study of CS\u2010STEMI patients from a large U.S. national database (National Inpatient Sample) between 2005 and 2014. Events were then divided into four different groups: no MCS, with intra\u2010aortic balloon pump, percutaneous ventricular assist device includes Impella or Tandem Heart or extracorporeal membrane oxygenation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Bleeding complications and ALI were observed in 31,389 (18.2%) and 1,628 (0.9%) out of 172,491 admissions with CS\u2010STEMI, respectively. Between 2005 and 2014, overall trends increased for ALI; however, the number of bleeding events decreased. ALI was associated with increased in\u2010hospital mortality in comparison to those without any ALI. However, bleeding complications were not associated with increased in\u2010hospital mortality. Compared to patients without complications, both bleeding and ALI were associated with increased length of stay (LOS) and hospitalization costs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Bleeding and ALI are common complications associated with CS\u2010STEMI in the contemporary era. Both complications are associated with increased hospital costs and LOS. These findings highlight the need to develop algorithms focused on vascular safety in CS\u2010STEMI.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.29003","type":"journal-article","created":{"date-parts":[[2020,5,30]],"date-time":"2020-05-30T19:18:47Z","timestamp":1590866327000},"page":"1129-1138","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Incidence and clinical outcomes of bleeding complications and acute limb ischemia in STEMI and cardiogenic shock"],"prefix":"10.1002","volume":"97","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7276-710X","authenticated-orcid":false,"given":"Mohit","family":"Pahuja","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine Detroit Medical Center\/Wayne State University School of Medicine  Detroit Michigan 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