{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T23:10:19Z","timestamp":1777936219965,"version":"3.51.4"},"reference-count":43,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"23","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2023,12,5]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Temporal trends in the management of acute coronary syndrome complicated with cardiogenic shock after the revision of guideline recommendations for intra\u2010aortic balloon pump (IABP) use and the approval of the Impella require further investigation, because their impact remains uncertain.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Using the Japanese Percutaneous Coronary Intervention (J\u2010PCI) registry database from 2019 to 2021, we identified 12\u2009171 patients undergoing percutaneous coronary intervention for acute coronary syndrome complicated with cardiogenic shock under mechanical circulatory support. The patients were stratified into 3 groups: (1) IABP alone, (2) Impella, and (3) venoarterial extracorporeal membrane oxygenation (VA\u2010ECMO); the VA\u2010ECMO group was further stratified into (3a) VA\u2010ECMO alone, (3b) VA\u2010ECMO in combination with IABP, and (3c) VA\u2010ECMO in combination with Impella. The quarterly prevalence and outcomes were reported. The use of IABP alone decreased significantly from 63.5% in the first quarter of 2019 to 58.3% in the fourth quarter of 2021 (\n              <jats:italic>P<\/jats:italic>\n              for trend=0.01). Among 4245 patients requiring VA\u2010ECMO, the use of VA\u2010ECMO in combination with IABP decreased significantly from 78.7% to 67.3%, whereas the use of VA\u2010ECMO in combination with Impella increased significantly from 4.2% to 17.0% (\n              <jats:italic>P<\/jats:italic>\n              for trend &lt;0.001 for both). After adjusting for the confounders, the risk difference in the fourth quarter of 2021 relative to the first quarter of 2019 for in\u2010hospital mortality was not significant (adjusted odds ratio, 0.84 [95% CI, 0.69\u20131.01]).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Our study revealed substantial changes in the use of different mechanical circulatory support modalities in acute coronary syndrome complicated with cardiogenic shock, but they did not significantly improve the outcomes.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.123.031838","type":"journal-article","created":{"date-parts":[[2023,12,1]],"date-time":"2023-12-01T11:43:39Z","timestamp":1701431019000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":19,"title":["Changing Trends in Mechanical Circulatory Support Use and Outcomes in Patients Undergoing Percutaneous Coronary Interventions for Acute Coronary Syndrome Complicated With Cardiogenic Shock: Insights From a Nationwide Registry in\u00a0Japan"],"prefix":"10.1161","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1996-8540","authenticated-orcid":false,"given":"Yuji","family":"Nishimoto","sequence":"first","affiliation":[{"name":"Division of Cardiology Osaka General Medical Center Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7889-2083","authenticated-orcid":false,"given":"Taku","family":"Inohara","sequence":"additional","affiliation":[{"name":"Department of Cardiology Keio University School of Medicine Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3779-2972","authenticated-orcid":false,"given":"Shun","family":"Kohsaka","sequence":"additional","affiliation":[{"name":"Department of Cardiology Keio University 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