Influence of Sepsis on Clinical Outcomes During Mechanical Circulatory Support by Microaxial Flow Pump in Patients with Cardiogenic Shock Following Acute Myocardial Infarction

Background: Cardiogenic shock (CS) is characterized as a state of low cardiac output that is frequently associated with multisystem organ failure. For over two decades, revascularization of the culprit lesion remained the only interventional treatment option to improve outcomes in CS following acute myocardial infarction. However, recently published data provide evidence that the use of a microaxial flow pump for mechanical circulatory support (MCS) in STEMI-related cardiogenic shock significantly reduced mortality after 180 days. Increased rates of complications such as sepsis were observed under MCS. The present study aimed to investigate the influence of sepsis on prognoses in patients with CS receiving temporary MCS with a microaxial flow pump. Methods and Results: This retrospective cohort study included 38 patients who received a microaxial flow pump for CS between 2014 and 2017. All patients were analyzed for the presence of sepsis, defined as infection and an increase in the Sequential Organ Failure Assessment (SOFA) score of ≥2 points. Analyzed clinical outcomes included all-cause mortality after 30 and 365 days and changes in renal function. A total of 38 patients were included in the final analysis. The 30-day all-cause mortality was significantly higher in the sepsis group than in the no-sepsis group (53.9% vs. 8.3%, p = 0.014). The findings were consistent for mortality at 365 days (65.4% vs. 16.7%, p = 0.008). Conclusions: These results indicate that sepsis significantly increases the risk of all-cause mortality at 30 and 365 days among patients with CS following AMI and receiving MCS via a microaxial flow pump.