Association of LVAD vs IABP with mortality, bleeding

Editor's Note

The use of an intravascular microaxial left ventricular assist device (LVAD) vs an intra-aortic balloon pump (IABP) in patients with acute myocardial infarction (AMI) complicated by cardiogenic shock was associated with worse in-hospital clinical outcomes in this study.

Of 3,360 propensity-matched patients undergoing percutaneous coronary intervention for AMI, there was a significantly higher risk of in-hospital death associated with use of an LVAD (45%) vs an IABP (34.1%). There also was a significantly higher risk of in-hospital major bleeding with an LVAD (31.3%) vs an IABP (16%). These findings were consistent regardless of the timing of device placement and transfer status.

The study interpretation may be limited by its observational design, and further research may be needed to understand the optimal device for these patients, the researchers say.