Acute cardiac care & resuscitationCohort study
In-hospital cardiac arrest in Impella-supported cardiogenic shock: insights from the J-PVAD registry
- registry
Authors' conclusion
IHCA before Impella implantation identified a distinct, high-risk CS phenotype with high mortality and a substantial complication burden. Metabolic, renal, and low-flow injury may support early risk stratification and clinical decision-making.
Study context
- Population
- J-PVAD patients with cardiogenic shock (CS) treated with ImpellaJ-PVAD patients with CS treated with Impella
- Participants
- 8,577 patients
- Exposure
- 30-day outcomes across four cardiac arrest presentations
- In-hospital cardiac arrest (IHCA)n = 1,924
- no cardiac arrestn = 4,595reference
- OHCA with return of spontaneous circulation (ROSC)n = 1,321
- OHCA without ROSCn = 737
- Outcome
- 30-day mortality from first Impella initiation
- Follow-up
- 30 days
Main finding
As reported in the abstract
Adjusted hazard ratio
1.54
95% CI 1.41–1.69
P < 0.001
By group
IHCA vs no cardiac arrest
adjusted HR 1.54 (95% CI 1.41–1.69); P < 0.001
Observational data: associations, not effects.
Further findings
Mortality-associated factors within IHCA
- older age, lactate >4.0 mmol/L, creatinine >1.5 mg/dL, longer arrest time, and venoarterial extracorporeal membrane oxygenation use were associated with higher mortality
- myocarditis and electrical defibrillation were associated with lower mortality
- Spline analyses showed nonlinear associations for lactate, creatinine, and arrest time
Original publication
In-hospital cardiac arrest in Impella-supported cardiogenic shock: insights from the J-PVAD registry. Resuscitation. Published 11 September 2026. doi:10.1016/j.resuscitation.2026.111310
Summarised from the published abstract; every number is checked against it