Abstract 12589: Left Ventricular Unloading Preserves Ventricular Function and Reduces New-Onset Atrial Fibrillation in Patients With Acute Myocardial Infarction Complicated by Cardiogenic Shock
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Media type:
E-Article
Title:
Abstract 12589: Left Ventricular Unloading Preserves Ventricular Function and Reduces New-Onset Atrial Fibrillation in Patients With Acute Myocardial Infarction Complicated by Cardiogenic Shock
Description:
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<jats:bold>Introduction:</jats:bold>
Left ventricular (LV) unloading by percutaneous ventricular assist device (pVAD) reduces myocardial workload and oxygen consumption and provides a new concept for improving outcome for acute myocardial infarction complicated with cardiogenic shock (AMI-CS). AMI results in reduced LV ejection fraction and left atrium remodeling, and increased the incidence of atrial fibrillation. The aim of this study is to investigate the effectiveness of LV unloading by pVAD in terms of mid-term mortality, LV function, and the incidence of atrial fibrillation.
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<jats:bold>Methods:</jats:bold>
We retrospectively reviewed AMI-CS patients who were admitted to our hospital between July 2014 and December 2021. We investigated patient demographics and baseline characteristics, mid-term clinical outcome, re-admission rate as well as new-onset atrial fibrillation compared between the patients supported with pVAD and without pVAD group during 180-day follow-up.
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<jats:bold>Results:</jats:bold>
A total of 82 AMI-CS patients treated with pVAD (n=54) or without pVAD (n=28) were analyzed. Mean age was 70±15 years old and 56 patients were male. Door to balloon time (110±56min vs. 91±53min, p=0.33) and Peak CK-MB (471.8±338mg/dl vs. 486.0±545mg/dl, p=0.43) were similar in both groups. During the 180-days follow-up, 23 patients died and 12 patients were re-hospitalized for heart failure (HF). New-onset atrial fibrillation occurred in 16 patients, which was significantly less frequent in pVAD group (11% vs. 36%. p=0.016). Between baseline and 180-days follow-up period, changes of LV ejection fraction (16% vs. 6%, p=0.02) and NT-proBNP (-28% vs. -5%, p=0.03) were significantly higher in pVAD group. There was no significant difference in 180-day all-cause mortality (28% vs. 29%, p=1.0) between the two groups. Multivariate logistic regression showed new-onset atrial fibrillation was independently associated with an increased risk of HF readmission (hazard ratio 2.63, 95% confidence interval 1.91-3.57; p=0.01).
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<jats:bold>Conclusion:</jats:bold>
pVAD support preserves LV function following ventricular unloading and reduces new-onset atrial fibrillation, which might be contributed to the improvement of mid-term outcome.
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