C-84 | Impact of End-Stage Renal Disease on Outcomes in Patients with Acute Myocardial Infarction Receiving Left Ventricular Assist Device: A Nationwide Readmission Analysis

Background: Mechanical circulatory support (MCS) devices, such as the Impella, are associated with improved outcomes in patients with cardiogenic shock post Myocardial Infarction (MI).However, the impact of malnutrition, a common comorbidity in this population, on outcomes remains understudied.We sought to evaluate the impact of malnutrition on outcomes in patients with CS secondary to MI, undergoing Impella implantation.Methods: This retrospective cohort study utilized data from the Tri-NetX database, a global health research network, and identified Patients with CS secondary to MI, who underwent Impella implantation.They were then stratified into two cohorts based on the presence or absence of malnutrition.Propensity score matching was performed based on demographics, comorbidities, and relevant clinical variables to achieve balanced cohorts and minimize confounding.Results: A total of 7,100 patients who underwent Impella implantation were included in this study, with the propensity score-matched cohorts comprising 1,571 patients each.Malnutrition was associated with a significantly higher risk of acute kidney injury (RR: 1.33, 95% CI: 1.23-1.43,p<0.001), cardiac arrest (RR: 1.20, 95% CI: 1.04-1.38,p0.013), and acute pulmonary embolism (RR: 2.12, 95% CI: 1.42-3.17,p<0.001).Additionally, malnourished patients were more likely to experience ischemic stroke (RR: 1.79, 95% CI: 1.43-2.23,p<0.001) and hemorrhagic stroke (RR: 2.35, 95% CI: 1.34-4.13,p0.002).However, the incidence of intraoperative bleeding did not differ significantly between the groups (p0.669).The malnourished cohort also exhibited a markedly higher readmission rate (RR: 1.31, 95% CI: 1.23-1.39,p<0.001).In contrast, no significant differences were observed in the incidence of all-cause mortality, aortic dissection, or critical limb ischemia.Conclusions: Malnourished individuals are at an increased risk for adverse outcomes following implantation of Impella for CS secondary to MI, particularly AKI, cardiac arrest, and pulmonary embolism.Assessing nutritional risk and timely intervention to improve nutritional status may significantly improve outcomes in this vulnerable cohort.