1097 PREDICTORS OF WEANING FROM TEMPORARY MECHANICAL CIRCULATORY SUPPORT IN PATIENTS WITH CARDIOGENIC SHOCK

Abstract Introduction In cardiogenic shock (CS) patients with temporary mechanical circulatory support (TMCS) the weaning process is crucial to verify patients’ myocardial recovery or device dependency. To date, there are no specific guidelines on strategies. Hypothesis We investigated clinical predictors of successful from TMCS and developed them a novel prognostic scoring system. Methods Eighty CS (62.5 ± 11.8 years, 86.2% male, 63.7% ACS) Impella were evaluated. Hemodynamic, echocardiographic laboratory data collected at admission (T0), 24 (T1), 48 (T2), 96 (T3) hours after implantation. classified according unsuccessful weaning, defined as hemodynamic/myocardial recovery, death/need for LVAD/heart transplant, respectively. Independent their discriminating cut-off values identified. Finally, score (W-Score) was derived. Results Thirty-eight (47.5%) showed (SW-group) while 42 (52.5%) (UW-group) TMCS. Clinical characteristics similar between two groups. SW-group higher T1, T2, T3 LVEF (p=0.013, p=0.001, p=0.001), T1 CPO (p=0.04), T2 MAP (p=0.019) lower inotropic (p=0.001, HR PCWP (p=0.01, p=0.008), creatinine (p=0.018, p=0.009), lactate (p=0.009, p=0.002) NT-proBNP (p=0.017, p=0.001). LVEF, together resulted independent SW (p<0.05). ≥ 10%, ≤ 8, 8068 ng/L, 1,59 mmol/L, 1,76 mg/dl identified (overall, AUC ≥0.7, p<0.05). W-Score enabling 7 (80% sensitivity, 85% specificity, 0.92, p <0.001). Conclusions W-Score, based LVEF/inotropic score/NT-proBNP, creatinine/lactate may be useful identify undergoing