C-107 | Comparing Outcomes Of Mechanical Circulatory Support In Cardiogenic Shock Secondary To Acute Coronary Syndrome Versus Other Causes: A Nationwide Observational Study

Background: The use of mechanical circulatory support in cardiogenic shock (CS) is increasing, with relative safety and efficacy being undetermined.We aimed to analyze the use of extracorporeal membranous oxygenation (ECMO) and impella in CS secondary to Takotsubo Cardiomyopathy (TCM).Methods: We identified hospitalizations with TCM and concomitant CS.We further divided these hospitalizations based on if they received ECMO vs impella support using their International Classification of Disease -10 Clinical Modification (ICD-10-CM) codes from the National Inpatient Sample (NIS) Database 2016-2020.We studied primary disease outcomes including mortality, length of stay (LOS) and total hospital charges (THC).Multivariate logistic regression and linear regression analyses were used to adjust for possible confounders.Results: Out of the 200,040 hospitalizations with TCM, 13,345 (6.6%) developed CS.Out of 13,345 with cardiogenic shock 93 (0.7%) received ECMO, with and 733 (5%) received impella.Those who received ECMO were younger 50.6 years vs 63.8 years.Interestingly, no significant difference was seen in ECMO vs impella for mortality (Adjusted odds ratio (aOR): 1.03, [95% Confidence Interval (CI) 0.32-3.38,p 0.958], THC of $1348700 ( 95% CI: 54783.3-278042,p0.49), and LOS (coefficient: 7.34, 95% CI 4.72-12.4,p 0.112).Additionally, no significant difference was seen in secondary outcomes including acute kidney injury (aOR: 0.24, CI: 0.04-1.49,p 0.129), cardiac arrest (aOR: 2.2, CI: 0.22-21.4,p 0.496), ischemic stroke (aOR: 0.51, CI: 0.03-7.89,p 0.634) or blood transfusion (aOR: 3.39, CI: 0.48-23.9,p 0.22).Conclusions: Patients admitted with TCM who developed CS, received impella more often than ECMO.No significant difference was found in primary outcomes including mortality, THC, and LOS.Additionally no significant difference was found in secondary outcomes including acute kidney injury, blood transfusion, cardiac arrest, or ischemic stroke.