J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website https://www.jocmr.org

Original Article

Volume 13, Number 5, May 2021, pages 283-292

Outcomes of Renal Function in Cardiogenic Shock Patients With or Without Mechanical Circulatory Support

Figure 1. Mean serum creatinine over time by device for patients with AKI prior to cardiac catheterization. AKI: acute kidney injury; IABP: intra-aortic balloon pump.

Figure 2. Mean eGFR over time by device for patients with AKI prior to cardiac catheterization. eGFR: estimated glomerular filtration rate; AKI: acute kidney injury; IABP: intra-aortic balloon pump.

Figure 3. Mean eGFR over time by device for patients with AKI after cardiac catheterization. eGFR: estimated glomerular filtration rate; AKI: acute kidney injury; IABP: intra-aortic balloon pump.

Figure 4. Mean serum creatinine over time by device for patients without AKI. AKI: acute kidney injury; IABP: intra-aortic balloon pump.

Figure 5. Mean eGFR over time by device for patients without AKI. eGFR: estimated glomerular filtration rate; AKI: acute kidney injury; IABP: intra-aortic balloon pump.

**Table 1.** Demographics and Clinical Characteristics
	All patients (n = 61)	IABP (n = 19)	Impella (n = 15)	Vasopressors only (n = 27)	P value
^aOnly 59 patients had charted data on presence of peripheral arterial disease. ^bOnly 53 patients had charted data on presence or absence of typical ACS symptoms. IQR: interquartile range; MI: myocardial infarction; CHF: congestive heart failure; PCI: percutaneous coronary intervention; CABG: coronary artery bypass graft; ACS: acute coronary syndrome; IABP: intra-aortic balloon pump; STEMI: ST-segment elevation myocardial infarction.
Age (median, IQR)	70.03 (62.27 - 79.64)	68.06 (58.47 - 78.76)	72.16 (65.25 - 81.58)	70.24 (62.81 - 73.69)	0.58
Males, n (%)	37 (60.7)	9 (47.4)	11 (73.3)	17 (63)	0.29
Body surface area (m²)	1.96 ± 0.03	1.95 ± 0.06	1.98 ± 0.06	1.96 ± 0.04	0.93
Prior MI, n (%)	11 (18)	2 (10.5)	0	9 (33.2)	0.016
Prior CHF, n (%)	8 (13.1)	3 (15.8)	0	5 (18.5)	0.215
Patients with known ejection fraction prior to intervention	30	10	8	12
Mean ejection fraction prior to catheterization	39.4 ± 16.7	39.4 ± 16.4	41.5 ± 15.2	37.9 ± 19.2	0.903
Diabetes, n (%)	16 (26.2)	8 (42.1)	1 (6.7)	7 (25.9)	0.066
Prior renal failure, n (%)	0 (0)	0 (0)	0 (0)	0 (0)
Prior dialysis, n (%)	0 (0)	0 (0)	0 (0)	0 (0)
Cerebrovascular disease, n (%)	3 (4.9)	1 (5.3)	1 (6.7)	1 (3.7)	0.91
Peripheral arterial disease^a, n (%)	4 (6.8)	2 (11.1)	0 (0)	2 (7.4)	0.456
Dyslipidemia, n (%)	41 (67.2)	11 (57.9)	11 (73.3)	19 (70.4)	0.57
Hypertension, n (%)	45 (76.3)	15 (83.3)	13 (92.9)	17 (63)	0.072
Smoking, n (%)	36 (59.01)	11 (18.03)	9 (14.75)	16 (26.22)	0.995
Prior PCI, n (%)	13 (22)	2 (11.1)	3 (21.4)	8 (29.6)	0.34
Prior CABG, n (%)	7 (11.5)	2 (10.5)	1 (6.7)	4 (14.8)	0.721
Prior valve surgery, n (%)	2 (4.1)	2 (13.3)	0 (0)	0 (0)	0.094
Typical ACS symptoms^b	31 (58.5)	9 (56.3)	7 (53.8)	15 (62.5)	0.857
ACS symptoms + STEMI^b	27 (50.9)	8 (50)	7 (53.8)	12 (50)	0.961

Table 1. Demographics and Clinical Characteristics

All patients (n = 61)

IABP (n = 19)

Impella (n = 15)

Vasopressors only (n = 27)

P value

^aOnly 59 patients had charted data on presence of peripheral arterial disease. ^bOnly 53 patients had charted data on presence or absence of typical ACS symptoms. IQR: interquartile range; MI: myocardial infarction; CHF: congestive heart failure; PCI: percutaneous coronary intervention; CABG: coronary artery bypass graft; ACS: acute coronary syndrome; IABP: intra-aortic balloon pump; STEMI: ST-segment elevation myocardial infarction.

Age (median, IQR)

70.03 (62.27 - 79.64)

68.06 (58.47 - 78.76)

72.16 (65.25 - 81.58)

70.24 (62.81 - 73.69)

0.58

Males, n (%)

37 (60.7)

9 (47.4)

11 (73.3)

17 (63)

0.29

Body surface area (m²)

1.96 ± 0.03

1.95 ± 0.06

1.98 ± 0.06

1.96 ± 0.04

0.93

Prior MI, n (%)

11 (18)

2 (10.5)

9 (33.2)

0.016

Prior CHF, n (%)

8 (13.1)

3 (15.8)

5 (18.5)

0.215

Patients with known ejection fraction prior to intervention

Mean ejection fraction prior to catheterization

39.4 ± 16.7

39.4 ± 16.4

41.5 ± 15.2

37.9 ± 19.2

0.903

Diabetes, n (%)

16 (26.2)

8 (42.1)

1 (6.7)

7 (25.9)

0.066

Prior renal failure, n (%)

0 (0)

Prior dialysis, n (%)

0 (0)

Cerebrovascular disease, n (%)

3 (4.9)

1 (5.3)

1 (6.7)

1 (3.7)

0.91

Peripheral arterial disease^a, n (%)

4 (6.8)

2 (11.1)

0 (0)

2 (7.4)

0.456

Dyslipidemia, n (%)

41 (67.2)

11 (57.9)

11 (73.3)

19 (70.4)

0.57

Hypertension, n (%)

45 (76.3)

15 (83.3)

13 (92.9)

17 (63)

0.072

Smoking, n (%)

36 (59.01)

11 (18.03)

9 (14.75)

16 (26.22)

0.995

Prior PCI, n (%)

13 (22)

2 (11.1)

3 (21.4)

8 (29.6)

0.34

Prior CABG, n (%)

7 (11.5)

2 (10.5)

1 (6.7)

4 (14.8)

0.721

Prior valve surgery, n (%)

2 (4.1)

2 (13.3)

0 (0)

0.094

Typical ACS symptoms^b

31 (58.5)

9 (56.3)

7 (53.8)

15 (62.5)

0.857

ACS symptoms + STEMI^b

27 (50.9)

8 (50)

7 (53.8)

12 (50)

0.961

**Table 2.** Use of Vasopressors/Inotropes in Relation to Cardiac Catheterization Lab Visit
Timing of vasopressor/inotrope use	IABP (n = 19)	Impella (n = 15)	Vasopressors alone (n = 27)	P value
IABP: intra-aortic balloon pump.
None use	3	2	0	0.111
Use initiated before lab visit	5	3	12	0.208
Use initiated during lab visit	8	9	12	0.532
Use initiated after lab visit	3	1	3	0.707

Table 2. Use of Vasopressors/Inotropes in Relation to Cardiac Catheterization Lab Visit

Timing of vasopressor/inotrope use

IABP (n = 19)

Impella (n = 15)

Vasopressors alone (n = 27)

P value

IABP: intra-aortic balloon pump.

None use

0.111

Use initiated before lab visit

0.208

Use initiated during lab visit

0.532

Use initiated after lab visit

0.707

**Table 3.** Mean Serum Creatinine With Standard Errors for Patients With AKI Prior to Catheterization
	Prior to catheterization	24 h	48 h	72 h	96 h
^aStatistically significant from baseline (prior to catheterization). ^bStatistically significant in comparison with vasopressors alone group. ^cStatistically significant in comparison with Impella. AKI: acute kidney injury. IABP: intra-aortic balloon pump; AKI: acute kidney injury.
Vasopressors alone	1.54 (0.07)	1.29 (0.15)	1.32 (0.28)	1.27 (0.27)	1.20 (0.2)
Impella	1.64 (0.22)	1.42 (0.15)	1.38 (0.29)	1.21 (0.27)^a	1.04 (0.07)^a
IABP	1.68 (0.21)	1.90 (0.23)^b	1.83 (0.26)	1.78 (0.26)	1.80 (0.3)^c

Table 3. Mean Serum Creatinine With Standard Errors for Patients With AKI Prior to Catheterization

Prior to catheterization

24 h

48 h

72 h

96 h

^aStatistically significant from baseline (prior to catheterization). ^bStatistically significant in comparison with vasopressors alone group. ^cStatistically significant in comparison with Impella. AKI: acute kidney injury. IABP: intra-aortic balloon pump; AKI: acute kidney injury.

Vasopressors alone

1.54 (0.07)

1.29 (0.15)

1.32 (0.28)

1.27 (0.27)

1.20 (0.2)

Impella

1.64 (0.22)

1.42 (0.15)

1.38 (0.29)

1.21 (0.27)^a

1.04 (0.07)^a

IABP

1.68 (0.21)

1.90 (0.23)^b

1.83 (0.26)

1.78 (0.26)

1.80 (0.3)^c

**Table 4.** Mean eGFR With Standard Errors for Patients With AKI Prior to Catheterization
	Prior to catheterization	24 h	48 h	72 h	96 h
^aStatistically significant from baseline. ^bStatistically significant in comparison with vasopressors alone group. eGFR: estimated glomerular filtration rate; AKI: acute kidney injury; IABP: intra-aortic balloon pump.
Vasopressors alone	46.56 (2.17)	62.64 (6)^a	69.29 (7.29)^a	70.69 (6.46)^a	73.60 (6.14)^a
Impella	44.42 (8.49)	51.48 (10.33)	58.48 (11.33)^a	69.28 (13.54)^a	70.75 (8.16)^a
IABP	43.71 (7.96)	37.9 (7.10)^b	41 (8.47)^b	43.42 (9.63)^b	45.07 (10.21)^b

Table 4. Mean eGFR With Standard Errors for Patients With AKI Prior to Catheterization

Prior to catheterization

24 h

48 h

72 h

96 h

^aStatistically significant from baseline. ^bStatistically significant in comparison with vasopressors alone group. eGFR: estimated glomerular filtration rate; AKI: acute kidney injury; IABP: intra-aortic balloon pump.

Vasopressors alone

46.56 (2.17)

62.64 (6)^a

69.29 (7.29)^a

70.69 (6.46)^a

73.60 (6.14)^a

Impella

44.42 (8.49)

51.48 (10.33)

58.48 (11.33)^a

69.28 (13.54)^a

70.75 (8.16)^a

IABP

43.71 (7.96)

37.9 (7.10)^b

41 (8.47)^b

43.42 (9.63)^b

45.07 (10.21)^b

**Table 5.** Mean eGFR With Standard Errors for Patients With AKI After Catheterization
	Prior to catheterization	24 h	48 h	72 h	96 h
^aStatistically significant from baseline. ^bSince only IABP group included only one patient, no SE was reported. eGFR: estimated glomerular filtration rate; AKI: acute kidney injury; IABP: intra-aortic balloon pump.
Vasopressors alone	59.51 (7.09)	35.57 (3.71)^a	31.10 (7.75)	37.10 (11.14)	47.06 (13.7)
Impella	60.41 (10.14)	38.83 (5.08)	38.26 (12.05)	39.95 (11.28)	44.81 (11.78)
IABP^b	75.51	25.50	10.56	12.72	19.30

Table 5. Mean eGFR With Standard Errors for Patients With AKI After Catheterization

Prior to catheterization

24 h

48 h

72 h

96 h

^aStatistically significant from baseline. ^bSince only IABP group included only one patient, no SE was reported. eGFR: estimated glomerular filtration rate; AKI: acute kidney injury; IABP: intra-aortic balloon pump.

Vasopressors alone

59.51 (7.09)

35.57 (3.71)^a

31.10 (7.75)

37.10 (11.14)

47.06 (13.7)

Impella

60.41 (10.14)

38.83 (5.08)

38.26 (12.05)

39.95 (11.28)

44.81 (11.78)

IABP^b

75.51

25.50

10.56

12.72

19.30

**Table 6.** Mean Serum Creatinine for Patients Without AKI
	Prior to catheterization	24 h	48 h	72 h	96 h
^aStatistically significant when compared to prior to catheterization. AKI: acute kidney injury; IABP: intra-aortic balloon pump.
Vasopressors alone	0.98 (0.11)	1.02 (0.11)	0.90 (0.14)	0.92 (0.12)	0.91 (0.12)
Impella	1.02 (0.15)	0.97 (0.19)	0.83 (0.12)^a	0.75 (0.10)^a	0.75 (0.10)^a
IABP	0.96 (0.05)	0.87 (0.04)	0.91 (0.08)	0.86 (0.10)	0.92 (0.08)

Table 6. Mean Serum Creatinine for Patients Without AKI

Prior to catheterization

24 h

48 h

72 h

96 h

^aStatistically significant when compared to prior to catheterization. AKI: acute kidney injury; IABP: intra-aortic balloon pump.

Vasopressors alone

0.98 (0.11)

1.02 (0.11)

0.90 (0.14)

0.92 (0.12)

0.91 (0.12)

Impella

1.02 (0.15)

0.97 (0.19)

0.83 (0.12)^a

0.75 (0.10)^a

IABP

0.96 (0.05)

0.87 (0.04)

0.91 (0.08)

0.86 (0.10)

0.92 (0.08)

**Table 7.** Mean eGFR for Patients Without AKI
	Prior to catheterization	24 h	48 h	72 h	96 h
^aStatistically significant when compared to baseline. eGFR: estimated glomerular filtration rate; AKI: acute kidney injury; IABP: intra-aortic balloon pump.
Vasopressors alone	71.29 (7.09)	67.81 (7.32)	79.04 (9.38)	76.81 (7.94)	78.26 (8.36)
Impella	74.78 (9.28)	78.96 (9.52)	87.13 (7.31)^a	91.96 (4.92)^a	91.89 (6.3)^a
IABP	68.97 (4.22)	76.44 (5.57)	75.26 (7.40)	81.04 (8.37)	77.49 (7.84)

Table 7. Mean eGFR for Patients Without AKI

Prior to catheterization

24 h

48 h

72 h

96 h

^aStatistically significant when compared to baseline. eGFR: estimated glomerular filtration rate; AKI: acute kidney injury; IABP: intra-aortic balloon pump.

Vasopressors alone

71.29 (7.09)

67.81 (7.32)

79.04 (9.38)

76.81 (7.94)

78.26 (8.36)

Impella

74.78 (9.28)

78.96 (9.52)

87.13 (7.31)^a

91.96 (4.92)^a

91.89 (6.3)^a

IABP

68.97 (4.22)

76.44 (5.57)

75.26 (7.40)

81.04 (8.37)

77.49 (7.84)