Eric P. Cantey, Aaron Lopacinski, Milan Seth, David E. Hamilton, Elias J. Dayoub, Siddharth Gandhi, Mir B. Basir, Amir Kaki, Ryan D. Madder, Devraj Sukul, Hitinder S. Gurm
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引用次数: 0
Abstract
Section snippets
Methods
The BMC2 registry is a quality improvement initiative of all nonfederal hospitals that perform percutaneous coronary intervention (PCI) in Michigan.3 Prospective patient-level data are collected through the NCDR (National Cardiovascular Data Registry) CathPCI system. Novel variables are also collected to drive statewide quality improvement.
Results
Of 24,744 primary PCIs for STEMI, 2,392 (9.7%) were complicated by AMI-CS. Of these, 927 (38.8%) were excluded primarily due to persistent neurologic deficit after cardiac arrest (n = 909; 38.0%). Among the remaining 1,465 patients, 724 (49.4%) were treated without MCS, 355 (24.2%) with IABP, 364 (24.9%) with mAFP, and 22 (1.5%) with other MCS (n = 14 for extracorporeal membrane oxygenation). Figure 1 shows annualized AMI-CS case volume and MCS utilization patterns by site. Each site treated a
Discussion
In a contemporary cohort of patients with AMI-CS with similar inclusion and exclusion criteria as the DanGer Shock trial: 1) there was low annual AMI-CS prevalence per site; 2) there was heterogeneous utilization of MCS for the treatment of AMI-CS; and 3) there was low utilization of intraprocedural RHC in AMI-CS.
Conclusions
AMI-CS is uncommonly encountered by most hospitals, resulting in limited experience with the use of mAFP. Successful translation of the DanGer Shock trial to contemporary care will require the implementation of shock protocols and hub and spoke partnerships to optimize the care and management of AMI-CS patients.
Funding Support and Author Disclosures
Support for BMC2 is provided by Blue Cross Blue Shield of Michigan (BCBSM) and Blue Care Network as part of the BCBSM Value Partnerships program. Although BCBSM and BMC2 work collaboratively, the opinions, beliefs and viewpoints expressed by the authors do not necessarily reflect the opinions, beliefs, and viewpoints of BCBSM or any of its employees. Further, BCBSM does not have access to BMC2 data, and all patient episodes occurring at engaged hospitals are included in the data registries,
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The Journal of the American College of Cardiology (JACC) publishes peer-reviewed articles highlighting all aspects of cardiovascular disease, including original clinical studies, experimental investigations with clear clinical relevance, state-of-the-art papers and viewpoints.
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