Outcomes of patients with cancer with myocardial infarction-associated cardiogenic shock managed with mechanical circulatory support

Authors

Orly Leiva, Division of Cardiology, Department of Medicine, New York University Grossman School of Medicine, New York, New York.
Richard K. Cheng, Division of Cardiology, University of Washington, Seattle, Washington.
Sunil Pauwaa, Advocate Health - MidwestFollow
Jason N. Katz, Division of Cardiology, Department of Medicine, Duke University, Durham, North Carolina.
Jose Alvarez-Cardona, Division of Cardiology, Department of Medicine, New York University Grossman School of Medicine, New York, New York.
Samuel Bernard, Division of Cardiology, Department of Medicine, New York University Grossman School of Medicine, New York, New York.
Carlos Alviar, Division of Cardiology, Department of Medicine, New York University Grossman School of Medicine, New York, New York.
Eric H. Yang, UCLA Cardio-Oncology Program, Division of Cardiology, Department of Medicine, University of California Los Angeles, Los Angeles, California.

Recommended Citation

Leiva O, Cheng RK, Pauwaa S, et al. Outcomes of Patients With Cancer With Myocardial Infarction-Associated Cardiogenic Shock Managed With Mechanical Circulatory Support. J Soc Cardiovasc Angiogr Interv. 2023;3(3Part A):101208. Published 2023 Nov 13. doi:10.1016/j.jscai.2023.101208

Affiliations

Advocate Christ Medical Center

Abstract

Background:Cardiogenic shock (CS) is the leading cause of death among patients with acute myocardial infarction (AMI) and is managed with temporary mechanical circulatory support (tMCS) in advanced cases. Patients with cancer are at high risk of AMI and CS. However, outcomes of patients with cancer and AMI-CS managed with tMCS have not been rigorously studied.

Methods:Adult patients with AMI-CS managed with tMCS from 2006 to 2018 with and without cancer were identified using the National Inpatient Sample. Propensity score matching (PSM) was performed for variables associated with cancer. Primary outcome was in-hospital death, and secondary outcomes were major bleeding and thrombotic complications.

Results:After PSM, 1287 patients with cancer were matched with 12,870 patients without cancer. There was an increasing temporal trend for prevalence of cancer among patients admitted with AMI-CS managed with tMCS ( P trend < .001). After PSM, there was no difference in in-hospital death (odds ratio [OR], 1.00; 95% CI, 0.88-1.13) or thrombotic complications (OR, 1.10; 95% CI, 0.91-1.34) between patients with and without cancer. Patients with cancer had a higher risk of major bleeding (OR, 1.29; 95% CI, 1.15-1.46).

Conclusions:Among patients with AMI-CS managed with tMCS, cancer is becoming increasingly frequent and associated with increased risk of major bleeding, although there was no difference in in-hospital death. Further studies are needed to further characterize outcomes, and inclusion of patients with cancer in trials of tMCS is needed.

Type

Article

PubMed ID

39131775