Predictors of device-related adverse events in patients with intra-aortic ballon pump or microaxial flow pump for cardiogenic shock.

Device-related adverse events (DRAEs) are common with intra-aortic balloon pump (IABP) and microaxial flow pump (mAFP) in cardiogenic shock (CS), yet predictors of DRAEs are underrecognized. We performed a single-center, retrospective review of consecutive adults from 8/2021 to 8/2024 with CS and IABP or mAFP. Events were adjudicated as device-related if occurring during IABP/mAFP support or <72 hours of removal. DRAEs included bleeding, bacteremia, stroke/transient ischemic attack, vascular injury, heparin-induced thrombocytopenia, and major hemolysis. Multivariable regression was performed to identify independent predictors of DRAEs. The study population (n = 400) was predominantly male (71.5%) with stage D/E CS (53.7%). In total, 251 DRAEs were identified. Independent DRAE predictors included non-white race, veno-arterial extracorporeal membrane oxygenation (VA-ECMO) exposure, outside hospital device placement, and >1 device, while IABP-only was protective. Among those with mAFP, VA-ECMO exposure, outside hospital device placement, and >1 device were independent DRAE predictors. Further investigation into DRAE prevention strategies is warranted.