{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T11:13:10Z","timestamp":1789557190557,"version":"build-2803163510"},"reference-count":44,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2024,6,4]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Evidence on the comparative outcomes following percutaneous microaxial ventricular assist devices (pVAD) versus intra\u2010aortic balloon pump for nonacute myocardial infarction cardiogenic shock is limited.<\/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\">We included 704 and 2140 Medicare fee\u2010for\u2010service beneficiaries aged 65 to 99\u2009years treated with pVAD and intra\u2010aortic balloon pump, respectively, for nonacute myocardial infarction cardiogenic shock from 2016 to 2020. Patients treated using pVAD compared with those treated using intra\u2010aortic balloon pump were more likely to be concurrently treated with mechanical ventilation, renal replacement therapy, and blood transfusions. We computed propensity scores for undergoing pVAD using patient\u2010 and hospital\u2010level factors and performed a matching weight analysis. The use of pVAD was associated with higher 30\u2010day mortality (adjusted odds ratio, 1.92 [95% CI, 1.59\u20132.33]) but not associated with in\u2010hospital bleeding (adjusted odds ratio, 1.00 [95% CI, 0.81\u20131.24]), stroke (adjusted odds ratio, 0.91 [95% CI, 0.56\u20131.47]), sepsis (OR, 0.91 [95% CI, 0.64\u20131.28]), and length of hospital stay (adjusted mean difference, +0.4\u2009days [95% CI, \u22121.4 to +2.3]). A quasi\u2010experimental instrumental variable analysis using the cross\u2010sectional institutional practice preferences showed similar patterns, though not statistically significant (adjusted odds ratio, 1.38; 95% CI, 0.28\u20136.89).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Our investigation using the national sample of Medicare beneficiaries showed that the use of pVAD compared with intra\u2010aortic balloon pump was associated with higher mortality in patients with nonacute myocardial infarction cardiogenic shock. Providers should be cautious about the use of pVAD for nonacute myocardial infarction cardiogenic shock, while adequately powered high\u2010quality randomized controlled trials are warranted to determine the clinical effects of pVAD.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.123.034645","type":"journal-article","created":{"date-parts":[[2024,5,28]],"date-time":"2024-05-28T10:07:25Z","timestamp":1716890845000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Percutaneous Microaxial Ventricular Assist Device Versus Intra\u2010Aortic Balloon Pump for Nonacute Myocardial Infarction Cardiogenic Shock"],"prefix":"10.1161","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8781-0329","authenticated-orcid":false,"given":"Atsuyuki","family":"Watanabe","sequence":"first","affiliation":[{"name":"Department of Medicine Mount Sinai Beth Israel Icahn School of Medicine at Mount Sinai New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2852-2946","authenticated-orcid":false,"given":"Yoshihisa","family":"Miyamoto","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Endocrinology The University of Tokyo Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroki","family":"Ueyama","sequence":"additional","affiliation":[{"name":"Division of Cardiology Emory University School of Medicine Atlanta GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4238-0171","authenticated-orcid":false,"given":"Hiroshi","family":"Gotanda","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine Cedars\u2010Sinai Medical Center Los Angeles CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1937-4833","authenticated-orcid":false,"given":"Yusuke","family":"Tsugawa","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine and Health Services Research David Geffen School of Medicine at The University of California, Los Angeles Los Angeles CA"},{"name":"Department of Health Policy and Management UCLA Fielding School of Public Health, Los Angeles Los Angeles CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2487-8366","authenticated-orcid":false,"given":"Toshiki","family":"Kuno","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Montefiore Medical Center Albert Einstein College of Medicine New York NY"},{"name":"Division of Cardiology, Jacobi Medical Center Albert Einstein College of Medicine New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.294.4.448"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00392-020-01781-z"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.121.021061"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.112.098194"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.119.044007"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.37748"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2022.2735"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2023.1664"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.05.065"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.10.022"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.acvd.2019.10.005"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2023.08.002"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.2796"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2023.1643"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.0254"},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.118.036614"},{"key":"e_1_3_1_18_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.121.009279"},{"key":"e_1_3_1_19_2","first-page":"931","article-title":"Patient characteristics, treatment and outcome in non\u2010ischemic vs. ischemic cardiogenic shock","volume":"9","author":"Schrage B","year":"2020","unstructured":"Schrage B, Weimann J, Dabboura S, Yan I, Hilal R, Becher PM, Seiffert M, Bernhardt AM, Kluge S, Reichenspurner H, et\u00a0al. 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