DOI: 10.1161/circ.148.suppl_1.12610 ISSN: 0009-7322

Abstract 12610: Outcomes of Patients With Cancer and Acute Myocardial Infarction-Associated Cardiogenic Shock Managed With Temporary Mechanical Circulatory Support

Orly Leiva, Eric H Yang, Richard K Cheng, Sunil Pauwaa, Jason N Katz, Jose Alvarez-Cardona, Samuel Bernard, Carlos L Alviar
  • Physiology (medical)
  • Cardiology and Cardiovascular Medicine

Introduction: Cardiogenic shock (CS) is a leading cause of in-hospital death among patients with acute myocardial infarction (AMI). Temporary mechanical circulatory support (tMCS) is used in AMI-CS and may improve end-organ perfusion at the risk of bleeding/thrombosis. Patients with cancer are at high risk of AMI and CS and are at risk of bleeding and thrombosis. However, there is limited data on the outcomes of patients with cancer and AMI-CS managed with tMCS.

Methods: Adult patients with AMI-CS managed with tMCS from January 2006 to December 2018 with and without cancer were identified within the National Inpatient Sample. Propensity score matching (PSM) was performed to match 1 cancer patient to 10 non-cancer controls. Primary outcome was in-hospital death and secondary outcomes were major bleeding and thrombotic complications. Temporal trends of tMCS use in cancer patients were investigated.

Results: Patient characteristics after PSM are described in Table. After PSM, 1,287 individuals with and 12,870 without cancer were included. Patient characteristics were well-balanced between cancer and non-cancer groups after PSM. After PSM, there was no difference in death (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 higher risk of major bleeding (OR 1.29, 95% CI 1.15 - 1.46).

Conclusions: Among patients hospitalized for AMI-CS managed with tMCS, cancer was associated with increased major bleeding but similar mortality and thrombotic risk. Future investigation is needed in order to further characterize and improve outcomes for this increasingly common patient population.

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