{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T03:44:42Z","timestamp":1785728682493,"version":"3.56.0"},"reference-count":41,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2021,4,2]],"date-time":"2021-04-02T00:00:00Z","timestamp":1617321600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1 TR000135"],"award-info":[{"award-number":["UL1 TR000135"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Racial disparities in utilization and outcomes of mechanical circulatory support (MCS) in patients with acute myocardial infarction-cardiogenic shock (AMI-CS) are infrequently studied. This study sought to evaluate racial disparities in the outcomes of MCS in AMI-CS. The National Inpatient Sample (2012\u20132017) was used to identify adult AMI-CS admissions receiving MCS support. MCS devices were classified as intra-aortic balloon pump (IABP), percutaneous left ventricular assist device (pLVAD) or extracorporeal membrane oxygenation (ECMO). Self-reported race was classified as white, black and others. Outcomes included in-hospital mortality, hospital length of stay and discharge disposition. During this period, 90,071 admissions were included with white, black and other races constituting 73.6%, 8.3% and 18.1%, respectively. Compared to white and other races, black race admissions were on average younger, female, with greater comorbidities, and non-cardiac organ failure (all p &lt; 0.001). Compared to the white race (31.3%), in-hospital mortality was comparable in black (31.4%; adjusted odds ratio (aOR) 0.98 (95% confidence interval (CI) 0.93\u20131.05); p = 0.60) and other (30.2%; aOR 0.96 (95% CI 0.92\u20131.01); p = 0.10). Higher in-hospital mortality was noted in non-white races with concomitant cardiac arrest, and those receiving ECMO support. Black admissions had longer lengths of hospital stay (12.1 \u00b1 14.2, 10.3 \u00b1 11.2, 10.9 \u00b1 1.2 days) and transferred less often (12.6%, 14.2%, 13.9%) compared to white and other races (both p &lt; 0.001). In conclusion, this study of AMI-CS admissions receiving MCS devices did not identify racial disparities in in-hospital mortality. Black admissions had longer hospital stay and were transferred less often. Further evaluation with granular data including angiographic and hemodynamic parameters is essential to rule out racial differences.<\/jats:p>","DOI":"10.3390\/jcm10071459","type":"journal-article","created":{"date-parts":[[2021,4,2]],"date-time":"2021-04-02T04:13:51Z","timestamp":1617336831000},"page":"1459","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Racial Disparities in the Utilization and Outcomes of Temporary Mechanical Circulatory Support for Acute Myocardial Infarction-Cardiogenic Shock"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4440-5945","authenticated-orcid":false,"given":"Rahul","family":"Vojjini","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7952-0217","authenticated-orcid":false,"given":"Sri Harsha","family":"Patlolla","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN 55905, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9954-9711","authenticated-orcid":false,"given":"Wisit","family":"Cheungpasitporn","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnav","family":"Kumar","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pranathi R.","family":"Sundaragiri","sequence":"additional","affiliation":[{"name":"Jen Care Senior Medical Center, ChenMed, Morrow, GA 30260, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5618-2750","authenticated-orcid":false,"given":"Rajkumar P.","family":"Doshi","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Nevada Reno School of Medicine, Reno, NV 89557, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allan S.","family":"Jaffe","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6353-6780","authenticated-orcid":false,"given":"Gregory W.","family":"Barsness","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David R.","family":"Holmes","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. Tanveer","family":"Rab","sequence":"additional","affiliation":[{"name":"Section of Interventional Cardiology, Division of Cardiovascular Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1631-8238","authenticated-orcid":false,"given":"Saraschandra","family":"Vallabhajosyula","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905, USA"},{"name":"Section of Interventional Cardiology, Division of Cardiovascular Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,4,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1016\/j.jcin.2015.10.039","article-title":"Temporal Trends and Outcomes of Patients Undergoing Percutaneous Coronary Interventions for Cardiogenic Shock in the Setting of Acute Myocardial Infarction: A Report From the CathPCI Registry","volume":"9","author":"Wayangankar","year":"2016","journal-title":"JACC Cardiovasc. Interv."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1007\/s00392-017-1182-2","article-title":"Trends in mechanical circulatory support use and hospital mortality among patients with acute myocardial infarction and non-infarction related cardiogenic shock in the United States","volume":"107","author":"Shah","year":"2018","journal-title":"Clin. Res. Cardiol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1992","DOI":"10.1161\/CIRCULATIONAHA.105.540948","article-title":"Comparison of percutaneous coronary intervention and coronary artery bypass grafting after acute myocardial infarction complicated by cardiogenic shock: Results from the Should We Emergently Revascularize Occluded Coronaries for Cardiogenic Shock (SHOCK) trial","volume":"112","author":"White","year":"2005","journal-title":"Circulation"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"27","DOI":"10.14797\/mdcj-16-1-27","article-title":"Acute Mechanical Circulatory Support for Cardiogenic Shock","volume":"16","author":"Telukuntla","year":"2020","journal-title":"Methodist Debakey Cardiovasc. J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1","DOI":"10.15420\/cfr.2019.02","article-title":"Temporary Mechanical Circulatory Support in Acute Heart Failure","volume":"6","author":"Jiritano","year":"2020","journal-title":"Card. Fail. Rev."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1776","DOI":"10.1161\/CIRCULATIONAHA.118.037655","article-title":"Sex Differences in In-Hospital Management and Outcomes of Patients With Acute Coronary Syndrome","volume":"139","author":"Hao","year":"2019","journal-title":"Circulation"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1489","DOI":"10.1016\/j.amjcard.2018.02.036","article-title":"Racial Differences in Quality of Care and Outcomes After Acute Coronary Syndrome","volume":"121","author":"Yong","year":"2018","journal-title":"Am. J. Cardiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1016\/S0735-1097(01)01432-2","article-title":"Acute myocardial infarction in the elderly: Differences by age","volume":"38","author":"Mehta","year":"2001","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1042","DOI":"10.1016\/j.amjcard.2005.06.033","article-title":"Racial and ethnic differences in the treatment and outcome of cardiogenic shock following acute myocardial infarction","volume":"96","author":"Palmeri","year":"2005","journal-title":"Am. J. Cardiol."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Vallabhajosyula, S., Dunlay, S.M., Barsness, G.W., Miller, P.E., Cheungpasitporn, W., Stulak, J.M., Rihal, C.S., Holmes, D.R., Bell, M.R., and Miller, V.M. (2020). Sex Disparities in the Use and Outcomes of Temporary Mechanical Circulatory Support for Acute Myocardial Infarction-Cardiogenic Shock. CJC Open.","DOI":"10.1016\/j.cjco.2020.06.001"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e006661","DOI":"10.1161\/CIRCHEARTFAILURE.119.006661","article-title":"Regional Variation in the Management and Outcomes of Acute Myocardial Infarction with Cardiogenic Shock in the United States","volume":"13","author":"Vallabhajosyula","year":"2020","journal-title":"Circ. Heart Fail."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1782","DOI":"10.1016\/j.amjcard.2020.03.025","article-title":"Frequency of Management of Cardiogenic Shock with Mechanical Circulatory Support Devices According to Race","volume":"125","author":"Kim","year":"2020","journal-title":"Am. J. Cardiol."},{"key":"ref_13","unstructured":"HCUP (2021, March 21). Introduction to HCUP National Inpatient Sample (NIS) 2012, Available online: https:\/\/www.hcup-us.ahrq.gov\/db\/nation\/nis\/NIS_Introduction_2012.jsp."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.ijcard.2020.02.033","article-title":"Acute myocardial infarction-cardiogenic shock in patients with prior coronary artery bypass grafting: A 16-year national cohort analysis of temporal trends, management and outcomes","volume":"310","author":"Vallabhajosyula","year":"2020","journal-title":"Int. J. Cardiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1781","DOI":"10.1016\/j.jacc.2019.01.053","article-title":"Acute Noncardiac Organ Failure in Acute Myocardial Infarction With Cardiogenic Shock","volume":"73","author":"Vallabhajosyula","year":"2019","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Lauridsen, M.D., Gammelager, H., Schmidt, M., Nielsen, H., and Christiansen, C.F. (2015). Positive predictive value of International Classification of Diseases, 10th revision, diagnosis codes for cardiogenic, hypovolemic, and septic shock in the Danish National Patient Registry. BMC Med. Res. Methodol., 15.","DOI":"10.1186\/s12874-015-0013-2"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1016\/j.cjca.2011.10.005","article-title":"Evaluation of care and surveillance of cardiovascular disease: Can we trust medico-administrative hospital data?","volume":"28","author":"Lambert","year":"2012","journal-title":"Can. J. Cardiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e010193","DOI":"10.1161\/JAHA.118.010193","article-title":"Temporary Mechanical Circulatory Support for Refractory Cardiogenic Shock Before Left Ventricular Assist Device Surgery","volume":"7","author":"Vallabhajosyula","year":"2018","journal-title":"J. Am. Heart Assoc."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1016\/j.amjcard.2018.10.029","article-title":"Trends, Predictors, and Outcomes of Temporary Mechanical Circulatory Support for Postcardiac Surgery Cardiogenic Shock","volume":"123","author":"Vallabhajosyula","year":"2019","journal-title":"Am. J. Cardiol."},{"key":"ref_20","unstructured":"Vallabhajosyula, S., Prasad, A., Sandhu, G.S., Bell, M.R., Gulati, R., Eleid, M.F., Best, P.J.M., Gersh, B.J., Singh, M., and Lerman, A. (2019). Mechanical Circulatory Support-Assisted Early Percutaneous Coronary Intervention in Acute Myocardial Infarction with Cardiogenic Shock: 10-Year National Temporal Trends, Predictors and Outcomes. EuroIntervention."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Ziaeian, B., Kominski, G.F., Ong, M.K., Mays, V.M., Brook, R.H., and Fonarow, G.C. (2017). National Differences in Trends for Heart Failure Hospitalizations by Sex and Race\/Ethnicity. Circ. Cardiovasc. Qual. Outcomes, 10.","DOI":"10.1161\/CIRCOUTCOMES.116.003552"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1130","DOI":"10.1097\/01.mlr.0000182534.19832.83","article-title":"Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data","volume":"43","author":"Quan","year":"2005","journal-title":"Med. Care"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2011","DOI":"10.1001\/jama.2017.17653","article-title":"Adherence to Methodological Standards in Research Using the National Inpatient Sample","volume":"318","author":"Khera","year":"2017","journal-title":"JAMA"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1007\/s00392-014-0767-2","article-title":"Gender differences in patients with cardiogenic shock complicating myocardial infarction: A substudy of the IABP-SHOCK II-trial","volume":"104","author":"Fengler","year":"2015","journal-title":"Clin. Res. Cardiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1016\/j.amjcard.2019.05.038","article-title":"Hospital-Level Disparities in the Outcomes of Acute Myocardial Infarction with Cardiogenic Shock","volume":"124","author":"Vallabhajosyula","year":"2019","journal-title":"Am. J. Cardiol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e000590","DOI":"10.1161\/JAHA.113.000590","article-title":"Trends in incidence, management, and outcomes of cardiogenic shock complicating ST-elevation myocardial infarction in the United States","volume":"3","author":"Kolte","year":"2014","journal-title":"J. Am. Heart Assoc."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"828","DOI":"10.1016\/S0195-668X(02)00844-8","article-title":"Early revascularization is associated with improved survival in elderly patients with acute myocardial infarction complicated by cardiogenic shock: A report from the SHOCK Trial Registry","volume":"24","author":"Dzavik","year":"2003","journal-title":"Eur. Heart J."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1002\/ccd.27427","article-title":"Feasibility of early mechanical circulatory support in acute myocardial infarction complicated by cardiogenic shock: The Detroit cardiogenic shock initiative","volume":"91","author":"Basir","year":"2018","journal-title":"Catheter. Cardiovasc. Interv."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1173","DOI":"10.1002\/ccd.28307","article-title":"Improved Outcomes Associated with the use of Shock Protocols: Updates from the National Cardiogenic Shock Initiative","volume":"93","author":"Basir","year":"2019","journal-title":"Catheter. Cardiovasc. Interv."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e005929","DOI":"10.1161\/CIRCHEARTFAILURE.119.005929","article-title":"Extracorporeal Membrane Oxygenation Use in Acute Myocardial Infarction in the United States, 2000 to 2014","volume":"12","author":"Vallabhajosyula","year":"2019","journal-title":"Circ. Heart Fail."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"941","DOI":"10.1001\/jamainternmed.2014.7856","article-title":"Trends in the use of percutaneous ventricular assist devices: Analysis of national inpatient sample data, 2007 through 2012","volume":"175","author":"Khera","year":"2015","journal-title":"JAMA Intern. Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1007\/s40119-019-00152-8","article-title":"Complications of Temporary Percutaneous Mechanical Circulatory Support for Cardiogenic Shock: An Appraisal of Contemporary Literature","volume":"8","author":"Subramaniam","year":"2019","journal-title":"Cardiol. Ther."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e013542","DOI":"10.1161\/JAHA.119.013542","article-title":"Trends in Acute Myocardial Infarction by Race and Ethnicity","volume":"9","author":"Chi","year":"2020","journal-title":"J. Am. Heart Assoc."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1177\/1089253209347385","article-title":"Extracorporeal life support: Utilization, cost, controversy, and ethics of trying to save lives","volume":"13","author":"Crow","year":"2009","journal-title":"Semin. Cardiothorac. Vasc. Anesth."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"e011954","DOI":"10.1161\/JAHA.119.011954","article-title":"Utilization of Palliative Care for Cardiogenic Shock Complicating Acute Myocardial Infarction: A 15-Year National Perspective on Trends, Disparities, Predictors, and Outcomes","volume":"8","author":"Vallabhajosyula","year":"2019","journal-title":"J. Am. Heart Assoc."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.resuscitation.2019.01.038","article-title":"Racial and ethnic differences in outcomes after out-of-hospital cardiac arrest: Hispanics and Blacks may fare worse than non-Hispanic Whites","volume":"137","author":"Bosson","year":"2019","journal-title":"Resuscitation"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1643","DOI":"10.1161\/CIRCULATIONAHA.117.033211","article-title":"Racial Differences in Long-Term Outcomes among Older Survivors of In-Hospital Cardiac Arrest","volume":"138","author":"Chen","year":"2018","journal-title":"Circulation"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1195","DOI":"10.1001\/jama.2009.1340","article-title":"American Heart Association National Registry of Cardiopulmonary Resuscitation, I. Racial differences in survival after in-hospital cardiac arrest","volume":"302","author":"Chan","year":"2009","journal-title":"JAMA"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1161\/01.CIR.0000079164.95019.5A","article-title":"Racial disparity in cardiac procedures and mortality among long-term survivors of cardiac arrest","volume":"108","author":"Groeneveld","year":"2003","journal-title":"Circulation"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1058","DOI":"10.1097\/MLR.0000000000000441","article-title":"Disparities in 30-Day Rehospitalization Rates Among Medicare Skilled Nursing Facility Residents by Race and Site of Care","volume":"53","author":"Li","year":"2015","journal-title":"Med. Care"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1448","DOI":"10.1377\/hlthaff.26.5.1448","article-title":"Separate and unequal: Racial segregation and disparities in quality across U.S. nursing homes","volume":"26","author":"Smith","year":"2007","journal-title":"Health Aff."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/7\/1459\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T13:33:34Z","timestamp":1760362414000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/7\/1459"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,2]]},"references-count":41,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2021,4]]}},"alternative-id":["jcm10071459"],"URL":"https:\/\/doi.org\/10.3390\/jcm10071459","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,2]]}}}