Results:

A total of 502 patients in 105 hospitals underwent VAD implantation for AMI compared to 9,727 patients in 143 hospitals who underwent VAD for other reasons. Patients with AMI had a higher prevalence of risk factors related to coronary artery disease, but were comparable in terms of age and gender. The patients with AMI were sicker, with 66.7% being implanted, while INTERMACS profile 1 compared to only 12.9% of non-MI patients. Patients implanted for AMI had a substantially higher prevalence of intra-aortic balloon pump, extracorporeal membrane oxygenation, and ventilatory support, and a higher prevalence of biventricular support (BiVADs and total artificial heart). Patients with AMI had a significantly higher rate of early complications. At 1 year, 52% of VAD patients who had AMI were alive with ongoing VAD support, 25.7% had been transplanted, 1.6% explanted for recovery, and 20.7% died on a device. Patients with AMI had similar adjusted early hazard (hazard ratio [HR], 0.89; p = 0.3) and lower adjusted late hazard for mortality (HR, 0.55; p = 0.02) when compared to those implanted for indications other than AMI.