Acute cardiac care & resuscitation

Impella and Venoarterial Extracorporeal Membrane Oxygenation in Cardiogenic Shock Complicating Acute Myocardial Infarction

Eur J Heart FailPublished Retrospective cohort study

Authors' conclusion

Overall, adverse event rates and resource consumption were high.

Study context

Population
Patients with acute MI-related cardiogenic shock treated with Impella and/or venoarterial extracorporeal membrane oxygenation (VA-ECMO), 2020–202120% of all AMICS cases
Participants
4,088 patients
Exposure
Impella vs VA-ECMO
Outcome
In-hospital mortality
Methodological detailsnationwide, claims data
  • Nationwide
  • Claims data

Main finding

As reported in the abstract

P = 0.001

Observational data: associations, not effects.

Further findings

Discharged home directly

P < 0.001

Discharged to another care facility

P = 0.031

Hospital stay and costs

Impella patients had shorter hospital stays and lower hospital costs

Safety

Adverse events

Acute haemorrhagic anaemia

Cerebrovascular accidents

Thromboembolisms of the extremities

SIRS

AKI

Acute liver failure

  • Adverse events: Acute haemorrhagic anaemia p < 0.001
  • Adverse events: Cerebrovascular accidents p < 0.001
  • Adverse events: Thromboembolisms p < 0.001
  • Adverse events: SIRS p = 0.004
  • Adverse events: AKI p < 0.001
  • Adverse events: Acute liver failure p < 0.001

Original publication

Impella and Venoarterial Extracorporeal Membrane Oxygenation in Cardiogenic Shock Complicating Acute Myocardial Infarction. Eur J Heart Fail. Published 18 September 2023. doi:10.1002/ejhf.3025

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