Prognostic Significance of Gait Recovery after Mechanical Circulatory Support Weaning in Acute Myocardial Infarction: A 14-Day Landmark Analysis

Objectives: : Gait function is associated with prognosis in patients with acute myocardial infarction (AMI). This study aimed to examine whether achieving ambulation of 50 m within 14 days after weaning from mechanical circulatory support (MCS) is associated with clinical outcomes in AMI patients treated with percutaneous coronary intervention (PCI) and MCS. Methods: : In this retrospective single-center cohort study, we included 91 patients with AMI who underwent primary PCI and required MCS between April 2015 and June 2023 and survived at least 14 days after MCS weaning. Gait ability at 14 days after MCS weaning was classified as gait recovery (walking ≥50 m), gait initiation (walking <50 m), or non-gait. The primary outcome was a composite of all-cause mortality or cardiovascular/cerebrovascular hospitalization within 1 year. Clinical outcomes were compared among groups using Kaplan-Meier analysis and the log-rank test. Results: : Of the 91 patients who survived 14 days after MCS weaning, 50 (55%) achieved gait recovery. These patients had more favorable clinical and functional profiles both at ICU admission and at the time of MCS weaning. Patients who achieved gait recovery had a lower incidence of 1-year clinical events than those in the gait initiation and non-gait groups, whereas outcomes in the gait initiation group were comparable to those in the non-gait group. No significant temporal differences were observed in gait recovery rates or clinical outcomes. Conclusions: : Achieving ambulation of at least 50 m within 14 days after MCS weaning was associated with better 1-year clinical outcomes in AMI patients requiring MCS.