{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,8]],"date-time":"2025-11-08T13:46:20Z","timestamp":1762609580982,"version":"3.38.0"},"reference-count":28,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,11,23]],"date-time":"2023-11-23T00:00:00Z","timestamp":1700697600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Previous studies have compared Impella use to intra\u2010aortic balloon pump (IABP) use in patients with acute myocardial infarction and cardiogenic shock (AMI\u2010CS) undergoing percutaneous coronary intervention (PCI). Our objective was to compare clinical outcomes in patients with AMI\u2010CS undergoing PCI who received Impella (percutaneous left ventricular assist device) without vasopressors, IABP without vasopressors, and vasopressors without mechanical circulatory support (MCS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We queried the National Inpatient Sample (NIS) using ICD\u201010 codes (2015\u20132018) to identify patients with AMI\u2010CS undergoing PCI. We created three propensity\u2010matched cohorts to examine clinical outcomes in patients receiving Impella versus\u00a0IABP, Impella versus vasopressors without MCS, and IABP versus vasopressors without MCS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 17,762 patients, Impella use was associated with significantly higher in\u2010hospital major bleeding (31.4% vs. 13.6%; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and hospital charges (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) compared to IABP use, with no benefit in mortality (34.1% vs. 26.9%; <jats:italic>p<\/jats:italic>\u2009=\u20090.06). Impella use was associated with significantly higher mortality (42.3% vs. 35.7%; <jats:italic>p<\/jats:italic>\u2009=\u20090.02), major bleeding (33.9% vs. 22.7%; <jats:italic>p<\/jats:italic>\u2009=\u20090.001), and hospital charges (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), when compared to the use of vasopressors without MCS. There were no significant differences in clinical outcomes between IABP use and the use of vasopressor without MCS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In this analysis of retrospective data of patients with AMI\u2010CS undergoing PCI, Impella use was associated with higher mortality, major bleeding, and in\u2010hospital charges when compared to vasopressor therapy without MCS. When compared to IABP use, Impella was associated with no mortality benefit, along with higher major bleeding events and in\u2010hospital charges. A vasopressor\u2010only strategy suggested no difference in clinical outcomes when compared to IABP. This study uses the NIS for the first time to highlight outcomes in AMI\u2010CS patients undergoing PCI when treated with vasopressor support without MCS, compared to Impella and IABP use.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.30913","type":"journal-article","created":{"date-parts":[[2023,11,24]],"date-time":"2023-11-24T06:23:18Z","timestamp":1700806998000},"page":"30-41","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Mechanical circulatory support versus vasopressors alone in patients with acute myocardial infarction and cardiogenic shock undergoing percutaneous coronary intervention"],"prefix":"10.1002","volume":"103","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2990-0224","authenticated-orcid":false,"given":"Awad I.","family":"Javaid","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Medicine Kirk Kerkorian School of Medicine at the University of Nevada Las Vegas Las Vegas Nevada 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H.","family":"Ahsan","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine Kirk Kerkorian School of Medicine at the University of Nevada Las Vegas Las Vegas Nevada USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc D.","family":"Feldman","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine The University of Texas Health at San Antonio San Antonio Texas 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