ECMO and impella increase stroke risk in acute myocardial infarction
Abstract There is limited data on the risk of stroke in patients with acute myocardial infarction (AMI) treated with temporary mechanical circulatory support devices. Retrospective data were extracted from the U.S. National Inpatient Sample between October 2015 and December 2020, involving hospitali...
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Nature Portfolio
2025-07-01
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| author | Jing Wu Chenguang Li Zheng Xu Baoguo Wang Mingyou Zhang |
| author_facet | Jing Wu Chenguang Li Zheng Xu Baoguo Wang Mingyou Zhang |
| author_sort | Jing Wu |
| collection | DOAJ |
| description | Abstract There is limited data on the risk of stroke in patients with acute myocardial infarction (AMI) treated with temporary mechanical circulatory support devices. Retrospective data were extracted from the U.S. National Inpatient Sample between October 2015 and December 2020, involving hospitalizations for AMI. The final cohort comprised: 4,370,069 hospitalizations with medical therapy only, 136,005 with intra-aortic balloon pump (IABP) only, 41,560 with Impella only, and 10,695 with extracorporeal membrane oxygenation (ECMO) utilized during hospitalization. The overall stroke rates for patients receiving medical therapy only, IABP only, Impella only, and ECMO were 3.39%, 3.56%, 4.54%, and 13.14%, respectively. Specifically, ischemic stroke rates were 2.93%, 3.17%, 3.96%, and 9.91%, and hemorrhagic stroke rates were 0.69%, 0.59%, 0.87%, and 4.77% for the respective groups. In stepwise forward Cox regression analysis, ECMO use was associated with the highest adjusted odds ratio (aOR) for overall stroke (aOR 3.04, 95% CI [2.66–3.48]), followed by Impella alone (aOR 1.79, 95% CI [1.61–2.00]) and atrial fibrillation (aOR 1.34, 95% CI [1.31–1.38]). However, IABP use showed no significant association with increased stroke risk in either univariate or multivariate analyses. While IABP use is not associated with an increased risk of ischemic or hemorrhagic stroke, ECMO and Impella use are linked to a higher stroke risk, particularly for ECMO-treated AMI. |
| format | Article |
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| institution | DOAJ |
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| language | English |
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| spelling | doaj-art-a36419c9e9364d00aadf8930504a693c2025-08-20T03:05:27ZengNature PortfolioScientific Reports2045-23222025-07-011511810.1038/s41598-025-10555-4ECMO and impella increase stroke risk in acute myocardial infarctionJing Wu0Chenguang Li1Zheng Xu2Baoguo Wang3Mingyou Zhang4Department of Translational Medicine, The First Hospital of Jilin UniversityDepartment of Cardiology, Zhongshan HospitalDepartment of Cardiovascular Diseases, The First Hospital of Jilin UniversityDepartment of Cardiovascular Diseases, The First Hospital of Jilin UniversityDepartment of Cardiovascular Diseases, The First Hospital of Jilin UniversityAbstract There is limited data on the risk of stroke in patients with acute myocardial infarction (AMI) treated with temporary mechanical circulatory support devices. Retrospective data were extracted from the U.S. National Inpatient Sample between October 2015 and December 2020, involving hospitalizations for AMI. The final cohort comprised: 4,370,069 hospitalizations with medical therapy only, 136,005 with intra-aortic balloon pump (IABP) only, 41,560 with Impella only, and 10,695 with extracorporeal membrane oxygenation (ECMO) utilized during hospitalization. The overall stroke rates for patients receiving medical therapy only, IABP only, Impella only, and ECMO were 3.39%, 3.56%, 4.54%, and 13.14%, respectively. Specifically, ischemic stroke rates were 2.93%, 3.17%, 3.96%, and 9.91%, and hemorrhagic stroke rates were 0.69%, 0.59%, 0.87%, and 4.77% for the respective groups. In stepwise forward Cox regression analysis, ECMO use was associated with the highest adjusted odds ratio (aOR) for overall stroke (aOR 3.04, 95% CI [2.66–3.48]), followed by Impella alone (aOR 1.79, 95% CI [1.61–2.00]) and atrial fibrillation (aOR 1.34, 95% CI [1.31–1.38]). However, IABP use showed no significant association with increased stroke risk in either univariate or multivariate analyses. While IABP use is not associated with an increased risk of ischemic or hemorrhagic stroke, ECMO and Impella use are linked to a higher stroke risk, particularly for ECMO-treated AMI.https://doi.org/10.1038/s41598-025-10555-4StrokeAcute myocardial infarctionTemporary mechanical circulatory supportImpellaIntra-aortic balloon counterpulsationExtracorporeal membrane oxygenation |
| spellingShingle | Jing Wu Chenguang Li Zheng Xu Baoguo Wang Mingyou Zhang ECMO and impella increase stroke risk in acute myocardial infarction Scientific Reports Stroke Acute myocardial infarction Temporary mechanical circulatory support Impella Intra-aortic balloon counterpulsation Extracorporeal membrane oxygenation |
| title | ECMO and impella increase stroke risk in acute myocardial infarction |
| title_full | ECMO and impella increase stroke risk in acute myocardial infarction |
| title_fullStr | ECMO and impella increase stroke risk in acute myocardial infarction |
| title_full_unstemmed | ECMO and impella increase stroke risk in acute myocardial infarction |
| title_short | ECMO and impella increase stroke risk in acute myocardial infarction |
| title_sort | ecmo and impella increase stroke risk in acute myocardial infarction |
| topic | Stroke Acute myocardial infarction Temporary mechanical circulatory support Impella Intra-aortic balloon counterpulsation Extracorporeal membrane oxygenation |
| url | https://doi.org/10.1038/s41598-025-10555-4 |
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