Impact of Social Determinants of Health on Mechanical Circulatory Support Use in ST-Elevation Myocardial Infarction With Cardiogenic Shock
Document Type
Conference Proceeding
Publication Date
5-2025
Publication Title
Journal of the Society for Cardiovascular Angiography and Interventions
Abstract
Background: Cardiogenic shock (CS) is a severe complication of STEMI, contributing to significant mortality despite advancements in revascularization and supportive care. Mechanical circulatory support (MCS) devices have shown potential to improve outcomes, however, their utilization remains suboptimal, with disparities in access and application noted among women, minorities, and socioeconomically disadvantaged groups. This study evaluates disparities in MCS use among STEMI-CS patients. Methods: Using the Nationwide Inpatient Sample (2016–2021), we identified 140,820 STEMI-CS patients using ICD-10 codes. Patients were stratified by MCS use, and logistic regression with subgroup analyses assessed disparities by sex, race, and socioeconomic factors. Propensity score matching was applied to compare in-hospital outcomes. Results: Among 140,820 patients, 26,505 (18.8%) received MCS. Females had 30% lower odds of MCS use (aOR 0.70, CI: 0.65–0.76, p< 0.001), while African American (aOR 0.85, CI: 0.75–0.97, p=0.016) and Asian (aOR 0.70, CI: 0.58–0.85, p< 0.001) patients had lower odds compared to Whites. Medicaid recipients had lower odds of MCS utilization compared to Medicare beneficiaries (aOR 0.87, CI: 0.76–0.99, p=0.039). Similarly, patients treated in urban teaching hospitals had substantially higher odds of MCS use (aOR 2.26, 95% CI: 1.80–2.83, p < 0.001) compared to rural facilities. Conclusions: Significant disparities in MCS utilization persist, influenced by sex, race, and socioeconomic factors. Addressing these inequities is critical to improving outcomes in patients with STEMI-CS.
Volume
4
Issue
5 Suppl
First Page
66
Last Page
67
Recommended Citation
Bahar AR, Bahar Y, Kidess GG, Kaur P, Ishaq S, Onal F, et a. [Alrayyashi M]. Impact of social determinants of health on mechanical circulatory support use in ST-elevation myocardial infarction with cardiogenic shock. J Soc Cardiovasc Angiogr Interv. 2025 May;4(5 Suppl):66-67. doi: 10.1016/j.jscai.2025.103512
DOI
10.1016/j.jscai.2025.103512
Comments
Society for Cardiovascular Angiography and Interventions SCAI 48th Annual Scientific Sessions, May 1-3, 2025, Washington, DC