98%
921
2 minutes
20
Background: Cardiogenic Shock (CS) complicating acute myocardial infarction (AMI) poses a significant mortality risk, suggesting the opportunity to implement effective mechanical circulatory support strategies. The comparative efficacy of Intra-Aortic Balloon Pump (IABP) and Impella in managing CS-AMI remains a subject of investigation.
Objective: This meta-analysis aims to evaluate the comparative effectiveness of Impella and IABP in managing CS-AMI, exploring mortality and adverse events.
Methods: A systematic search of major databases from inception to November 2023 identified eight studies, comprising 10,628 patients, comparing Impella and IABP in CS-AMI. Retrospective studies (preferably Propensity-matched) and Randomized Clinical Trials (RCTs) were included.
Results: Impella use exhibited significantly higher mortality (57% vs. 46%; OR: 1.44, 95% CI: 1.29-1.60; p < 0.001) and major bleeding (30% vs 15%; OR: 2.93, 95% CI: 1.67-5.13; p < 0.001).
Conclusions: In unselected CS-AMI patients, Impella usage is associated with significantly higher mortality and major bleeding.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1016/j.ijcard.2024.132411 | DOI Listing |
Eur Heart J Open
September 2025
Calderdale and Huddersfield NHS Foundation Trust, Acre St, Lindley, Huddersfield HD3 3EA, UK.
Aims: Cardiogenic shock remains a significant cause of mortality despite multiple advancements in medical interventions. Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) provides crucial circulatory support but also increases left ventricular (LV) after-load, potentially worsening outcomes. Effective LV unloading strategies can enhance patient survival during VA-ECMO treatment.
View Article and Find Full Text PDFEur Heart J Qual Care Clin Outcomes
August 2025
Centennial Heart at Parkridge, Parkridge Medical Center, Chattanooga, TN, USA.
Background: Racial disparities in outcomes for patients requiring temporary mechanical circulatory support (tMCS) after acute myocardial infarction (AMI) remain unclear.
Objective: To evaluate racial disparities in patients requiring tMCS following AMI.
Methods: Using the TriNetX US collaborative network (2009-2023), we identified non-Hispanic Black (NHB) and non-Hispanic White (NHW) adults who had AMI and required tMCS.
Clin Transplant
August 2025
Department of Cardiovascular and Thoracic Surgery, University of Louisville School of Medicine, Louisville, Kentucky, USA.
Background: The new United Network of Organ Sharing (UNOS) allocation policy emphasizes those supported by mechanical circulatory support devices (MCSD). We evaluated the outcomes based on temporary mechanical circulatory support (TMCS) devices that have a timeline restriction (Status 1: Veno-Arterial Extra-Corporeal Membrane Oxygenation (VA-ECMO) and Status 2: Intra-Aortic Balloon Pump (IABP) and Impella) and extension status among Status 1 and 2 patients.
Methods: The UNOS database was used to identify adult patients (age > 17) listed for heart transplants as Status 1 or 2 at any point during their listing from October 2018 to June 2024.
J Clin Med
August 2025
Department of Critical Care Medicine, Christian Medical College, Vellore 632004, India.
: High-risk percutaneous coronary interventions (HR-PCIs) often require mechanical circulatory support (MCS) to maintain hemodynamic stability. Intra-aortic balloon pump (IABP) and percutaneous left ventricular assist device (PLVAD) are two commonly used MCS devices that differ in their mechanisms. We aimed to evaluate and compare the clinical outcomes associated with IABP and PLVAD use in HR-PCIs without cardiogenic shock.
View Article and Find Full Text PDFInt J Artif Organs
August 2025
College of Pharmacy, Dubai Medical University, Dubai, UAE.
Background: The combination of VA-ECMO and Impella, known as "ECpella" offers an alternative to the method of left ventricle unloading with intra-aortic balloon pump (IABP). Limited information is available to inform anticoagulation management in cases of concomitant use of Mechanical Circulatory Support (MCS) devices.
Methods: This retrospective study included 34 patients receiving hemodynamic support through concomitant MCS for cardiogenic shock for a duration exceeding 24 h.