Mechanical circulatory support in cardiogenic shock from acute myocardial infarction: Impella CP/5.0 versus ECMO.
Acute Disease
Aged
Extracorporeal Membrane Oxygenation
/ adverse effects
Female
Heart Failure
/ classification
Heart-Assist Devices
/ adverse effects
Hospital Mortality
Humans
Male
Middle Aged
Myocardial Infarction
/ complications
Percutaneous Coronary Intervention
/ methods
Retrospective Studies
Shock, Cardiogenic
/ etiology
Survival Analysis
Treatment Outcome
Impella
Mechanical circulatory support
acute heart failure
cardiogenic shock
extracorporeal membrane oxygenation
Journal
European heart journal. Acute cardiovascular care
ISSN: 2048-8734
Titre abrégé: Eur Heart J Acute Cardiovasc Care
Pays: England
ID NLM: 101591369
Informations de publication
Date de publication:
Mar 2020
Mar 2020
Historique:
pubmed:
30
7
2019
medline:
28
11
2020
entrez:
30
7
2019
Statut:
ppublish
Résumé
Short-term mechanical circulatory support devices are increasingly used in cardiogenic shock after acute myocardial infarction. As no randomised evidence is available, the choice between high-output Impella or extra-corporeal membrane oxygenation (ECMO) is still a matter of debate. Real-life data are necessary to assess adverse outcomes and to help guide the treatment decision between the different devices. The purpose of this study was to compare characteristics and clinical outcomes of Impella CP/5.0 with ECMO support in patients with cardiogenic shock from myocardial infarction. A retrospective, two-centre study was performed on all cardiogenic shock from myocardial infarction patients with Impella CP/5.0 or ECMO support, from 2006 until 2018. The primary outcome was 30-day mortality. Potential baseline imbalance between the groups was adjusted using inverse probability treatment weighting, and survival analysis was performed with an adjusted log-rank test. Secondarily, the occurrence of device-related complications (limb ischaemia, access site-related bleeding, access site-related infection) was evaluated. A total of 128 patients were included (Impella, Patients treated with Impella CP/5.0 or ECMO for cardiogenic shock after myocardial infarction did not differ in 30-day mortality. More device-related complications occurred with ECMO compared to Impella support.
Sections du résumé
BACKGROUND
BACKGROUND
Short-term mechanical circulatory support devices are increasingly used in cardiogenic shock after acute myocardial infarction. As no randomised evidence is available, the choice between high-output Impella or extra-corporeal membrane oxygenation (ECMO) is still a matter of debate. Real-life data are necessary to assess adverse outcomes and to help guide the treatment decision between the different devices. The purpose of this study was to compare characteristics and clinical outcomes of Impella CP/5.0 with ECMO support in patients with cardiogenic shock from myocardial infarction.
METHODS
METHODS
A retrospective, two-centre study was performed on all cardiogenic shock from myocardial infarction patients with Impella CP/5.0 or ECMO support, from 2006 until 2018. The primary outcome was 30-day mortality. Potential baseline imbalance between the groups was adjusted using inverse probability treatment weighting, and survival analysis was performed with an adjusted log-rank test. Secondarily, the occurrence of device-related complications (limb ischaemia, access site-related bleeding, access site-related infection) was evaluated.
RESULTS
RESULTS
A total of 128 patients were included (Impella,
CONCLUSIONS
CONCLUSIONS
Patients treated with Impella CP/5.0 or ECMO for cardiogenic shock after myocardial infarction did not differ in 30-day mortality. More device-related complications occurred with ECMO compared to Impella support.
Identifiants
pubmed: 31353918
doi: 10.1177/2048872619865891
doi:
Types de publication
Comparative Study
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM