Outcomes and Readmissions of ST-Elevation Myocardial Infarction With Cardiogenic Shock Patients Supported by Temporary Mechanical Circulatory Support

Introduction: Despite advances in the field of temporary mechanical circulatory support (TMCS), in-hospital mortality and morbidity related to cardiogenic shock due to ST elevation myocardial infarction (CS-STEMI) remain high. Hypothesis: We sought to investigate readmissions and respective outcomes among patients with CS-STEMI supported by TMCS. Methods: The National Readmission Database (NRD) was queried to identify adults who were admitted with CS-STEMI between 2016 and 2018 using the International Classification of Diseases, Tenth Revision (ICD-10) codes. Patients with sepsis, pulmonary embolism, cardiac tamponade, aortic dissection, or missing data were excluded. Results: A total of 7,501 patients did not undergo TMCS implantation, while the rest received various types of TMCS (ECMO alone: n=3,659; IABP alone: n=1,268; Impella alone: n=293; ECMO with IABP or Impella: n=525). Readmissions occurred in 16.7% and 25.1% by 30 and 90 days, respectively, with most readmissions occurring in patients requiring ECMO and IABP or Impella ( Table 1 ). Multivariable logistic regression revealed age, female gender, diabetes, prior CABG, previous stroke, liver disease and Elixhauser score as risk factors for in-hospital mortality ( Table 2 ). Conclusions: Our study has unveiled several important factors associated with readmission and mortality. Approaches to identify and prevent readmissions early after TCMS by addressing these factors may lead to lower morbidity, healthcare cost related to readmission, and improved quality of life.