Racial and ethnic disparities in utilization of mechanical circulatory support for cardiogenic shock following acute myocardial infarction: a retrospective cross-sectional study.

Background: Mechanical circulatory support (MCS) is critical in the management of cardiogenic shock (CS) complicating acute myocardial infarction (AMI), but racial/ethnic disparities in MCS utilization remain understudied. Methods: We extracted data from the National Inpatient Sample database for the years 2018 to 2020. Patients aged ≥18 years with AMI and CS listed as primary or secondary diagnosis were identified using ICD-10-CM. The primary outcome was in-hospital mortality. Secondary outcomes included MCS utilization, hospital length of stay (LOS), total hospital charges, acute kidney injury (AKI)/hemodialysis, and sepsis. Multivariable logistic and linear regression models were used to assess associations between race/ethnicity and in-hospital outcomes. Results: Among 89 125 hospitalizations for AMI and CS, Hispanics had lower in-hospital mortality than Whites (OR 0.86; 95% CI, 0.76-0.96). The MCS use was higher among Asians or Pacific Islanders (OR 1.35; 95% CI, 1.14-1.60) and Hispanics (OR 1.15; 95% CI, 1.01-1.30) than among Whites. Hispanics had longer LOS ( Conclusion: Racial and ethnic disparities in MCS use and clinical outcomes persist among patients with AMI and CS.