Acute cardiac care & resuscitationCohort study
Impella and Venoarterial Extracorporeal Membrane Oxygenation in Cardiogenic Shock Complicating Acute Myocardial Infarction
- Retrospective cohort study
- nationwide
- claims data
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
Main finding
As reported in the abstract
In-hospital mortality
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
Summarised from the published abstract; every number is checked against it