D-23 | Outcomes of Impella Use in Acute Myocardial Infarction Complicated by Cardiogenic Shock

Cardiogenic Shock (CS) has a high mortality rate. Impella is used in Acute myocardial infarction complicated by cardiogenic shock (AMI-CS). There are conflicting results about its efficacy. This is an analysis of the National Inpatient Sample of the years 2016 to 2020. We identified patients who were admitted with a principal diagnosis of AMI-CS. The risk of mortality and in-hospital complications in the impella group was compared to the non-impella group using multivariate logistic regression analysis. During 2016-2020, there were a total of 339, 740 AMI-CS admissions in the US of which 34315 (10. 1%) patients underwent Impella placement. 28. 26% were women. The mean age was 65. 7 years. Mean total cost of care was 438454. After adjusting for demographics and PCI status, Impella use in AMI –CS has higher odds of in-hospital mortality (aOR (adjusted odds ratio) 1. 93; 95% CI 1. 814–2. 05 p<0. 001), GI bleed (aOR (adjusted odds ratio) 1. 36; 95% CI 1. 22–1. 504 p<0. 001), stroke (aOR (adjusted odds ratio) 1. 22; 95% CI 1. 06–1. 40 p=0. 004), arrhythmia (aOR (adjusted odds ratio) 1. 23; 95% CI 1. 15–1. 30, p<0. 001 compared to the patients without impella use in AMI-CS. There was no difference in the outcomes of subsequent MI and transfusion between the two groups. (Table 1). Mean total cost of care was higher in the impella group compared to non-impella group. Our study shows increased odds of in-hospital mortality, GI bleed, stroke, and arrhythmia in patients with impella in AMI-CS. Further observational studies and RCTs are needed.