{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T06:01:44Z","timestamp":1784354504748,"version":"3.55.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2021,12,31]],"date-time":"2021-12-31T00:00:00Z","timestamp":1640908800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Japanese Society of Cardiovascular Interventional Therapeutics (CVIT) and the Health and Labor Sciences Research Grant"},{"name":"Comprehensive Research on Life-Style-Related Disease including Cardiovascular Diseases and Diabetes Mellitus","award":["20FA1018"],"award-info":[{"award-number":["20FA1018"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,1,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>Although primary percutaneous coronary intervention (PCI) and mechanical circulatory support (MCS), such as extracorporeal membrane oxygenation (ECMO) or intra-aortic balloon pumping (IABP), have been widely used for acute myocardial infarction (AMI) patients with cardiogenic shock (AMICS), their in-hospital mortality remains high. This study aimed to investigate the association of cardiovascular healthcare resources with 30-day mortality in AMICS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>This was an observational study using a Japanese nationwide administrative data (JROAD-DPC) of 260\u200a543 AMI patients between April 2012 and March 2018. Of these, 45\u200a836 AMICS patients were divided into three categories based on MCS use: with MCS (ECMO with\/without IABP), IABP only, or without MCS. Certified hospital density and number of board-certified cardiologists were used as a metric of cardiovascular healthcare resources. We estimated the association of MCS use, cardiovascular healthcare resources, and 30-day mortality. The 30-day mortality was 71.2% for the MCS, 23.9% for IABP only, and 37.8% for the group without MCS. The propensity score-matched and inverse probability-weighted Cox frailty models showed that primary PCI was associated with a low risk for mortality. Higher hospital density and larger number of cardiologists in the responsible hospitals were associated with a lower risk for mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Although the 30-day mortality remained extremely high in AMICS, indication of primary PCI and improvement in providing cardiovascular healthcare resources associated with the short-term prognosis of AMICS.<\/jats:p><\/jats:sec>","DOI":"10.1093\/ehjopen\/oeab047","type":"journal-article","created":{"date-parts":[[2021,12,31]],"date-time":"2021-12-31T16:57:34Z","timestamp":1640969854000},"source":"Crossref","is-referenced-by-count":14,"title":["Resources for cardiovascular healthcare associated with 30-day mortality in acute myocardial infarction with cardiogenic shock"],"prefix":"10.1093","volume":"2","author":[{"given":"Masanobu","family":"Ishii","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University , 1-1-1, Honjo, Chuo-ku, Kumamoto 860-8556, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenichi","family":"Tsujita","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University , 1-1-1, Honjo, Chuo-ku, Kumamoto 860-8556, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Okamoto","sequence":"additional","affiliation":[{"name":"Cardiovascular Medicine, Kawasaki Medical School , 577, Matsushima, Kurashiki, Okayama 701-0192, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Koto","sequence":"additional","affiliation":[{"name":"Cardiovascular Medicine, Kawasaki Medical School , 577, Matsushima, Kurashiki, Okayama 701-0192, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Nishi","sequence":"additional","affiliation":[{"name":"Cardiovascular Medicine, Kawasaki Medical School , 577, Matsushima, Kurashiki, Okayama 701-0192, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2240-1510","authenticated-orcid":false,"given":"Michikazu","family":"Nakai","sequence":"additional","affiliation":[{"name":"National Cerebral and Cardiovascular Center , 6-1 Kishibe-Shimmachi, Suita, Osaka 564-8565, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoko","family":"Sumita","sequence":"additional","affiliation":[{"name":"National Cerebral and Cardiovascular Center , 6-1 Kishibe-Shimmachi, Suita, Osaka 564-8565, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshitaka","family":"Iwanaga","sequence":"additional","affiliation":[{"name":"National Cerebral and Cardiovascular Center , 6-1 Kishibe-Shimmachi, Suita, Osaka 564-8565, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuyoshi","family":"Azuma","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Asahikawa Medical University , 2-1-1-1, Midorigaoka higashi, Asahikawa, Hokkaido 078-8510, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoaki","family":"Matoba","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine , 465 Kawaramachi-Hirokoji, Kajii-cho, Kamigyo-ku, Kyoto 602-8566, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken-Ichi","family":"Hirata","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine , 7-5-1 Kusunoki-chou, Chuo-ku, Kobe, Hyogo 650-0017, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yutaka","family":"Hikichi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Saga-Ken Medical Centre Koseikan , 400 Kasemachinakabaru, Saga-shi, Saka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyoshi","family":"Yokoi","sequence":"additional","affiliation":[{"name":"Cardiovascular Center, Fukuoka Sanno Hospital , 3-6-45, Momochihama, Sawara-ku, Fukuoka 814-0001, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5686-4324","authenticated-orcid":false,"given":"Yuji","family":"Ikari","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Tokai University School of Medicine , 143 Shimokasuya, Isehara-shi, Kanagawa 259-1193, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiro","family":"Uemura","sequence":"additional","affiliation":[{"name":"Cardiovascular 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