Abstract 12617: Predictors of Mortality in African Americans Requiring Intra-Aortic Balloon Pump for Cardiogenic Shock Following Acute Myocardial Infarction

Introduction: Past studies have linked African Americans(AA) to disparities in care and outcome. We aim to improve the care of AA by evaluating the predictors of mortality in AA requiring an intra-aortic balloon pump(IABP) for cardiogenic shock(CS) following acute myocardial infarction (AMI).

Methods: Variables influencing mortality among AA adults with CS from AMI using intra-aortic balloon pump (IABP), were studied via the 2016-2020 National Inpatient Sample.

Results: Our study found 9050 cases of AMI with CS among AA that required IABP and 3100 (34.3%) of them died. Odds of mortality were higher in those ages ≥60(aOR 1.356, p<0.01), using mechanical ventilation (aOR 2.725, p<0.01), with ventricular tachycardia (aOR 1.231, p<0.01), ventricular fibrillation (aOR 2.215, p<0.01), prior stroke (aOR 1.319, p<0.01), Chronic Kidney Disease (aOR 1.387, p<0.01), cirrhosis (aOR 2.581, p<0.01), hypertension (aOR 1.29, p<0.01), peripheral vascular disease (aOR 1.218, p =0.031), acute kidney injury (aOR 1.281, p<0.01), and females (aOR 1.111, p=0.042). Lower odds were reported in those with lipid disorders (aOR 0.713, p<0.01), alcohol abuse (aOR 0.549, p<0.01), depression (aOR 0.676, p<0.01), drug abuse (aOR 0.483, p<0.01), events of supraventricular tachycardia (0.438, p<0.01), atrial fibrillation (aOR 0.88, p=0.042), smoking (aOR 0.727, p<0.01), obesity (aOR 0.843, p=0.011), and weekend admissions (aOR 0.867, p<0.01). Furthermore, Medicaid (aOR 0.705, p<0.01) and Private Insurers (aOR 0.550, p<0.01) showed reduced risk compared to Medicare-covered patients. Urban non-teaching (aOR 0.52, p<0.01) and Urban teaching(aOR 0.526, p<0.01) centers also had reduced mortality rates (vs. Rural hospitals).

Conclusions: We found several patient and hospital characteristics that can influence the survival of AA using IABP for CS following AMI. Further research to improve the impact of these factors and alleviate their negative roles on survival should be encouraged.