Which induction agent for myocardial infarction patients requiring invasive mechanical ventilation ?

Patients with acute myocardial infarction requiring invasive mechanical ventilation have a high mortality. In this study, researchers evaluated the association between induction agent and mortality in 5,147 patients in this setting. They compared clinical outcomes between those receiving propofol (1,386 patients) and those receiving etomidate (3,761 patients). Patients in the propofol group were more likely to require vasoactive medication prior to intubation and mechanical circulatory support. The use of propofol was associated with lower mortality than etomidate, even after data adjustment. Total cost, days on ventilator and length of stay were higher in the propofol group.