Outcomes with mechanical circulatory support devices among patients with mechanical complications of acute myocardial infarction

AIMS: The aim of this study is to examine the trends and outcomes of mechanical circulatory support (MCS) device use among patients with mechanical complications of acute myocardial infarction (AMI). METHODS AND RESULTS: Using data from the National Inpatient Sample (a large admirative database in the USA) years 2016-20, we identified AMI admissions (ST-elevation and non-ST-elevation myocardial infarction) with mechanical complications (ventricular septal defect, free wall rupture, or papillary muscle rupture). Among 4 450 219 AMI patients, 7025 (0.2%) had a mechanical complication of which 3115 patients (44.3%) received at least one MCS device. There was a rising trend in MCS use (39.3% in 2016 to 48.9% in 2020, Ptrend = 0.02), but there was no corresponding reduction in the incidence of in-hospital mortality (36.9% in 2016 vs. 43.4% in 2020, Ptrend = 0.75). There was no significant difference in in-hospital mortality between those who received MCS vs. those who did not (48.4 vs. 34.5%, respectively). CONCLUSION: In this large observational analysis of AMI hospitalizations, mechanical complications were rare and associated with very high in-hospital mortality. Although the use of MCS has increased, in-hospital mortality rates remain high even among patients who received MCS. Further investigations are needed to clarify the role of MCS devices among patients with mechanical complications of AMI.