PMID- 37671582
OWN - NLM
STAT- MEDLINE
DCOM- 20231216
LR  - 20231218
IS  - 1879-0844 (Electronic)
IS  - 1388-9842 (Linking)
VI  - 25
IP  - 11
DP  - 2023 Nov
TI  - Impella and venoarterial extracorporeal membrane oxygenation in cardiogenic shock 
      complicating acute myocardial infarction.
PG  - 2021-2031
LID - 10.1002/ejhf.3025 [doi]
AB  - AIMS: This study aimed to give contemporary insight into the use of Impella and 
      venoarterial extracorporeal membrane oxygenation (VA-ECMO) in acute myocardial 
      infarction-related cardiogenic shock (AMICS) and into associated outcomes, 
      adverse events, and resource demands. METHODS AND RESULTS: This nationwide 
      observational cohort study describes all AMICS patients treated with Impella 
      (ABIOMED, Danvers, MA, USA) and/or VA-ECMO in 2020-2021. Impella and/or VA-ECMO 
      were used in 20% of all AMICS cases (n = 4088). Impella patients were older (34% 
      vs. 13% >75 years, p < 0.001) and less frequently presented after an 
      out-of-hospital cardiac arrest (18% vs. 40%, p < 0.001). In-hospital mortality 
      was lower in the Impella versus VA-ECMO cohort (61% vs. 67%, p = 0.001). Adverse 
      events occurred less frequently in Impella-supported patients: acute haemorrhagic 
      anaemia (36% vs. 68%, p < 0.001), cerebrovascular accidents (4% vs. 11%, 
      p < 0.001), thromboembolisms of the extremities (5% vs. 8%, p < 0.001), systemic 
      inflammatory response syndrome (21% vs. 25%, p = 0.004), acute kidney injury (44% 
      vs. 53%, p < 0.001), and acute liver failure (7% vs. 12%, p < 0.001). Impella 
      patients were discharged home directly more often (20% vs. 11%, p < 0.001) 
      whereas VA-ECMO patients were more often discharged to another care facility (22% 
      vs. 19%, p = 0.031). Impella patients had shorter hospital stays and lower 
      hospital costs. CONCLUSION: This is the largest, most recent European cohort 
      study describing outcomes, adverse events, and resource demands based on claims 
      data in patients with Impella and/or VA-ECMO. Overall, adverse event rates and 
      resource consumption were high. Given the current lack of beneficial evidence, 
      our study reinforces the need for prospectively established, high-quality 
      evidence to guide clinical decision-making.
CI  - (c) 2023 The Authors. European Journal of Heart Failure published by John Wiley & 
      Sons Ltd on behalf of European Society of Cardiology.
FAU - Bogerd, Margriet
AU  - Bogerd M
AD  - Department of Cardiology, Amsterdam University Medical Centre, University of 
      Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands.
FAU - Ten Berg, Sanne
AU  - Ten Berg S
AD  - Department of Cardiology, Amsterdam University Medical Centre, University of 
      Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands.
FAU - Peters, Elma J
AU  - Peters EJ
AD  - Department of Cardiology, Amsterdam University Medical Centre, University of 
      Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands.
FAU - Vlaar, Alexander P J
AU  - Vlaar APJ
AD  - Department of Intensive Care, Amsterdam University Medical Centre, University of 
      Amsterdam, Amsterdam, The Netherlands.
FAU - Engstrom, Annemarie E
AU  - Engstrom AE
AD  - Department of Intensive Care, Amsterdam University Medical Centre, University of 
      Amsterdam, Amsterdam, The Netherlands.
FAU - Otterspoor, Luuk C
AU  - Otterspoor LC
AD  - Department of Cardiology and Department of Intensive Care Medicine, Catharina 
      Hospital, Eindhoven, The Netherlands.
FAU - Jung, Christian
AU  - Jung C
AD  - Department of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, 
      Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany.
FAU - Westermann, Dirk
AU  - Westermann D
AD  - Department of Cardiology and Angiology, University Heart Centre, University 
      Freiburg, Freiburg, Germany.
FAU - Poss, Janine
AU  - Poss J
AD  - Department of Internal Medicine/Cardiology, Heart Centre Leipzig at the 
      University of Leipzig and Leipzig Heart Science, Leipzig, Germany.
FAU - Thiele, Holger
AU  - Thiele H
AD  - Department of Internal Medicine/Cardiology, Heart Centre Leipzig at the 
      University of Leipzig and Leipzig Heart Science, Leipzig, Germany.
FAU - Schrage, Benedikt
AU  - Schrage B
AD  - Department of Cardiology, University Heart and Vascular Centre Hamburg, Hamburg, 
      Germany.
FAU - Henriques, Jose P S
AU  - Henriques JPS
AD  - Department of Cardiology, Amsterdam University Medical Centre, University of 
      Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20230918
PL  - England
TA  - Eur J Heart Fail
JT  - European journal of heart failure
JID - 100887595
SB  - IM
DRIN- Eur J Heart Fail. 2023 Nov;25(11):2032-2033. PMID: 37828765
CIN - Eur J Heart Fail. 2023 Nov;25(11):2034-2036. PMID: 37828786
MH  - Humans
MH  - Shock, Cardiogenic/etiology/therapy
MH  - *Extracorporeal Membrane Oxygenation/methods
MH  - Cohort Studies
MH  - *Heart Failure/etiology
MH  - *Heart-Assist Devices/adverse effects
MH  - *Myocardial Infarction/complications
MH  - Retrospective Studies
OTO - NOTNLM
OT  - Acute myocardial infarction
OT  - Adverse events
OT  - Cardiogenic shock
OT  - Impella
OT  - Resource demands
OT  - Venoarterial extracorporeal membrane oxygenation
EDAT- 2023/09/06 06:42
MHDA- 2023/12/17 09:43
CRDT- 2023/09/06 05:27
PHST- 2023/08/30 00:00 [revised]
PHST- 2023/06/02 00:00 [received]
PHST- 2023/08/31 00:00 [accepted]
PHST- 2023/12/17 09:43 [medline]
PHST- 2023/09/06 06:42 [pubmed]
PHST- 2023/09/06 05:27 [entrez]
AID - 10.1002/ejhf.3025 [doi]
PST - ppublish
SO  - Eur J Heart Fail. 2023 Nov;25(11):2021-2031. doi: 10.1002/ejhf.3025. Epub 2023 
      Sep 18.