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July 31, 2026Expert Review of Medical Devices

Percutaneous left ventricular assist device in cardiogenic shock associated with and without acute myocardial infarction: a real-world retrospective cohort study

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Why the study?

Outcomes with pLVAD may differ between AMI-CS and non-AMI CS due to differing pathophysiology and trajectories.

Does percutaneous left ventricular assist device (pLVAD) support in AMI-related cardiogenic shock result in worse outcomes compared to non-AMI cardiogenic shock in adults?

Population

Adults with CS treated with pLVAD, propensity matched into two cohorts of n = 2,026 each

Comparison

AMI-CS vs non-AMI CS

Design

Retrospective cohort study

Follow-up

180 days

Key result

Among patients with cardiogenic shock treated with pLVAD, acute myocardial infarction-related shock was associated with higher 30-day mortality compared to non-AMI shock (HR 1.19, p=0.002).

Authors

RVRoopeessh VempatiJGJOHN GALLAGHERHHHaidar Hajeh

Discussion

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Overview

In real-world practice, patients receiving pLVAD for AMI-related cardiogenic shock experience higher short- and medium-term mortality and heart failure-related morbidity than those with non-AMI cardiogenic shock.

Key Points

  • To compare outcomes of percutaneous left ventricular assist device in cardiogenic shock due to acute myocardial infarction and non-acute causes.
  • Identified adults with cardiogenic shock treated with pLVAD from 2016 to 2024 using the TriNetX Network.
  • Defined AMI-CS as myocardial infarction within seven days of implantation; excluded patients with recent coronary artery bypass graft.
  • Matched cohorts of 2,026 each for balanced comparison.
  • Patients with AMI-CS had higher 30-day mortality (HR 1.19, p = 0.002) compared to non-AMI CS.
  • Heart failure exacerbations were more common in AMI-CS (HR 1.21, p < 0.001).
  • Pulmonary edema occurred more frequently in AMI-CS patients (HR 1.23, p = 0.005).

Study Design

Type

Cohort (n=11,394)

Multicenter

Yes

Structured PICO

Does percutaneous left ventricular assist device (pLVAD) support in AMI-related cardiogenic shock result in worse outcomes compared to non-AMI cardiogenic shock in adults?

P
Population
11,394 adults with cardiogenic shock treated with pLVAD (4,052 in propensity-matched cohorts, mean age 63, 26% female), excluding recent CABG, followed for up to 180 days.
E
Exposure
Percutaneous left ventricular assist device (pLVAD) for acute myocardial infarction-related cardiogenic shock (AMI-CS, defined by MI within 7 days of implantation).
C
Comparator
Percutaneous left ventricular assist device (pLVAD) for non-AMI cardiogenic shock (heterogeneous etiologies such as decompensated cardiomyopathy, myocarditis, valvular failure, pulmonary vascular causes, and arrhythmic shock).
O
Outcome
Mortality at 30 days, 90 days, and 180 dayshard clinical

Main Result

Hazard Ratio: 1.19

p-value: p=0.002

In real-world practice, patients receiving pLVAD for AMI-related cardiogenic shock experience higher short- and medium-term mortality and heart failure-related morbidity than those with non-AMI cardiogenic shock.

Cite This Study

Vempati et al. (2026) conducted a cohort in Cardiogenic shock treated with pLVAD (n=11,394). Acute myocardial infarction-related cardiogenic shock (AMI-CS) vs. Non-AMI cardiogenic shock (non-AMI CS) was evaluated on Mortality at 30 days (HR 1.19, p=0.002). Among patients with cardiogenic shock treated with pLVAD, acute myocardial infarction-related shock was associated with higher 30-day mortality compared to non-AMI shock (HR 1.19, p=0.002).

synapsesocial.com/papers/6a6c46e6747664a1aa73bd0ehttps://doi.org/10.1080/17434440.2026.2710388
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Intraaortic Balloon Support for Myocardial Infarction with Cardiogenic Shock2012 · 2,862 citations
  2. 2Clinical Outcomes and Cost Associated With an Intravascular Microaxial Left Ventricular Assist Device vs Intra-aortic Balloon Pump in Patients Presenting With Acute Myocardial Infarction Complicated by Cardiogenic Shock2022 · 104 citations
  3. 3Epidemiology and causes of cardiogenic shock2021 · 92 citations
  4. 4Cardiogenic Shock in Older Adults: A Focus on Age-Associated Risks and Approach to Management: A Scientific Statement From the American Heart Association2024 · 69 citations
  5. 5Timing and Causes of Death in Acute Myocardial Infarction Complicated by Cardiogenic Shock (from the RETROSHOCK Cohort)2022 · 36 citations