PMID- 38038195
OWN - NLM
STAT- MEDLINE
DCOM- 20231207
LR  - 20231220
IS  - 2047-9980 (Electronic)
IS  - 2047-9980 (Linking)
VI  - 12
IP  - 23
DP  - 2023 Dec 5
TI  - 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 Japan.
PG  - e031838
LID - 10.1161/JAHA.123.031838 [doi]
LID - e031838
AB  - BACKGROUND: Temporal trends in the management of acute coronary syndrome 
      complicated with cardiogenic shock after the revision of guideline 
      recommendations for intra-aortic balloon pump (IABP) use and the approval of the 
      Impella require further investigation, because their impact remains uncertain. 
      METHODS AND RESULTS: Using the Japanese Percutaneous Coronary Intervention 
      (J-PCI) registry database from 2019 to 2021, we identified 12 171 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-ECMO); the VA-ECMO group was 
      further stratified into (3a) VA-ECMO alone, (3b) VA-ECMO in combination with 
      IABP, and (3c) VA-ECMO 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 (P for 
      trend=0.01). Among 4245 patients requiring VA-ECMO, the use of VA-ECMO in 
      combination with IABP decreased significantly from 78.7% to 67.3%, whereas the 
      use of VA-ECMO in combination with Impella increased significantly from 4.2% to 
      17.0% (P for trend <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-hospital mortality was not significant (adjusted odds ratio, 0.84 
      [95% CI, 0.69-1.01]). CONCLUSIONS: 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.
FAU - Nishimoto, Yuji
AU  - Nishimoto Y
AUID- ORCID: 0000-0003-1996-8540
AD  - Division of Cardiology Osaka General Medical Center Osaka Japan.
FAU - Inohara, Taku
AU  - Inohara T
AUID- ORCID: 0000-0002-7889-2083
AD  - Department of Cardiology Keio University School of Medicine Tokyo Japan.
FAU - Kohsaka, Shun
AU  - Kohsaka S
AUID- ORCID: 0000-0003-3779-2972
AD  - Department of Cardiology Keio University School of Medicine Tokyo Japan.
FAU - Sakakura, Kenichi
AU  - Sakakura K
AUID- ORCID: 0000-0003-3566-0394
AD  - Division of Cardiovascular Medicine, Saitama Medical Center Jichi Medical 
      University Saitama Japan.
FAU - Kawai, Tsutomu
AU  - Kawai T
AUID- ORCID: 0000-0003-3567-6556
AD  - Division of Cardiology Osaka General Medical Center Osaka Japan.
FAU - Kikuchi, Atsushi
AU  - Kikuchi A
AD  - Division of Cardiology Osaka General Medical Center Osaka Japan.
FAU - Watanabe, Tetsuya
AU  - Watanabe T
AUID- ORCID: 0000-0003-3979-527X
AD  - Division of Cardiology Osaka General Medical Center Osaka Japan.
FAU - Yamada, Takahisa
AU  - Yamada T
AD  - Division of Cardiology Osaka General Medical Center Osaka Japan.
FAU - Fukunami, Masatake
AU  - Fukunami M
AD  - Division of Cardiology Osaka General Medical Center Osaka Japan.
FAU - Yamaji, Kyohei
AU  - Yamaji K
AUID- ORCID: 0000-0002-8798-9186
AD  - Department of Cardiology Kyoto University Kyoto Japan.
FAU - Ishii, Hideki
AU  - Ishii H
AUID- ORCID: 0000-0003-4348-0123
AD  - Department of Cardiovascular Medicine Gunma University Graduate School of 
      Medicine Maebashi Japan.
FAU - Amano, Tetsuya
AU  - Amano T
AUID- ORCID: 0000-0002-6833-3675
AD  - Department of Cardiology Aichi Medical University Nagakute Japan.
FAU - Kozuma, Ken
AU  - Kozuma K
AD  - Department of Cardiology Teikyo University Hospital Tokyo Japan.
CN  - J-PCI Registry Investigators
LA  - eng
PT  - Journal Article
DEP - 20231201
PL  - England
TA  - J Am Heart Assoc
JT  - Journal of the American Heart Association
JID - 101580524
SB  - IM
MH  - Humans
MH  - Shock, Cardiogenic/epidemiology/etiology/therapy
MH  - *Acute Coronary Syndrome/complications/therapy
MH  - *Percutaneous Coronary Intervention/adverse effects
MH  - Japan/epidemiology
MH  - Registries
MH  - Intra-Aortic Balloon Pumping/adverse effects
MH  - *Heart-Assist Devices/adverse effects
MH  - Treatment Outcome
PMC - PMC10727314
OTO - NOTNLM
OT  - Impella
OT  - cardiogenic shock
OT  - epidemiology
OT  - extracorporeal membrane oxygenation
OT  - intra-aortic balloon pumping
OT  - mechanical circulatory support
EDAT- 2023/12/01 12:42
MHDA- 2023/12/07 12:41
PMCR- 2023/12/05
CRDT- 2023/12/01 06:53
PHST- 2023/12/07 12:41 [medline]
PHST- 2023/12/01 12:42 [pubmed]
PHST- 2023/12/01 06:53 [entrez]
PHST- 2023/12/05 00:00 [pmc-release]
AID - JAH39051 [pii]
AID - 10.1161/JAHA.123.031838 [doi]
PST - ppublish
SO  - J Am Heart Assoc. 2023 Dec 5;12(23):e031838. doi: 10.1161/JAHA.123.031838. Epub 
      2023 Dec 1.