Research output: Contribution to journal › Article › Academic › peer-review
Real-life use of left ventricular circulatory support with Impella in cardiogenic shock after acute myocardial infarction : 12 years AMC experience. / Ouweneel, Dagmar M; de Brabander, Justin; Karami, Mina et al.
In: European heart journal. Acute cardiovascular care, Vol. 8, No. 4, 06.2019, p. 338-349.Research output: Contribution to journal › Article › Academic › peer-review
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TY - JOUR
T1 - Real-life use of left ventricular circulatory support with Impella in cardiogenic shock after acute myocardial infarction
T2 - 12 years AMC experience
AU - Ouweneel, Dagmar M
AU - de Brabander, Justin
AU - Karami, Mina
AU - Sjauw, Krischan D
AU - Engström, Annemarie E
AU - Vis, M Marije
AU - Wykrzykowska, Joanna J
AU - Beijk, Marcel A
AU - Koch, Karel T
AU - Baan, Jan
AU - de Winter, Robbert J
AU - Piek, Jan J
AU - Lagrand, Wim K
AU - Cherpanath, Thomas Gv
AU - Driessen, Antoine Hg
AU - Cocchieri, Riccardo
AU - de Mol, Bas Ajm
AU - Tijssen, Jan Gp
AU - Henriques, José Ps
PY - 2019/6
Y1 - 2019/6
N2 - AIMS: Mortality in cardiogenic shock patients remains high. Short-term mechanical circulatory support with Impella can be used to support the circulation in these patients, but data from randomised controlled studies and 'real-world' data are sparse. The aim is to describe real-life data on outcomes and complications of our 12 years of clinical experience with Impella in patients with cardiogenic shock after acute myocardial infarction and to identify predictors of 6-month mortality.METHODS: We describe a single-centre registry from October 2004 to December 2016 including all patients treated with Impella for cardiogenic shock after acute myocardial infarction. We report outcomes and complications and identify predictors of 6-month mortality.RESULTS: Our overall clinical experience consists of 250 patients treated with Impella 2.5, Impella CP or Impella 5.0. A total of 172 patients received Impella therapy for cardiogenic shock, of which 112 patients had cardiogenic shock after acute myocardial infarction. The mean age was 60.1±10.6 years, mean arterial pressure was 67 (56-77) mmHg, lactate was 6.2 (3.6-9.7) mmol/L, 87.5% were mechanically ventilated and 59.6% had a cardiac arrest before Impella placement. Overall 30-day mortality was 56.2% and 6-month mortality was 60.7%. Complications consisted of device-related vascular complications (17.0%), non-device-related bleeding (12.5%), haemolysis (7.1%) and stroke (3.6%). In a multivariate analysis, pH before Impella placement is a predictor of 6-month mortality.CONCLUSIONS: Our registry shows that Impella treatment in cardiogenic shock after acute myocardial infarction is feasible, although mortality rates remain high and complications occur.
AB - AIMS: Mortality in cardiogenic shock patients remains high. Short-term mechanical circulatory support with Impella can be used to support the circulation in these patients, but data from randomised controlled studies and 'real-world' data are sparse. The aim is to describe real-life data on outcomes and complications of our 12 years of clinical experience with Impella in patients with cardiogenic shock after acute myocardial infarction and to identify predictors of 6-month mortality.METHODS: We describe a single-centre registry from October 2004 to December 2016 including all patients treated with Impella for cardiogenic shock after acute myocardial infarction. We report outcomes and complications and identify predictors of 6-month mortality.RESULTS: Our overall clinical experience consists of 250 patients treated with Impella 2.5, Impella CP or Impella 5.0. A total of 172 patients received Impella therapy for cardiogenic shock, of which 112 patients had cardiogenic shock after acute myocardial infarction. The mean age was 60.1±10.6 years, mean arterial pressure was 67 (56-77) mmHg, lactate was 6.2 (3.6-9.7) mmol/L, 87.5% were mechanically ventilated and 59.6% had a cardiac arrest before Impella placement. Overall 30-day mortality was 56.2% and 6-month mortality was 60.7%. Complications consisted of device-related vascular complications (17.0%), non-device-related bleeding (12.5%), haemolysis (7.1%) and stroke (3.6%). In a multivariate analysis, pH before Impella placement is a predictor of 6-month mortality.CONCLUSIONS: Our registry shows that Impella treatment in cardiogenic shock after acute myocardial infarction is feasible, although mortality rates remain high and complications occur.
KW - Adult
KW - Female
KW - Follow-Up Studies
KW - Forecasting
KW - Heart-Assist Devices
KW - Hospital Mortality/trends
KW - Humans
KW - Male
KW - Middle Aged
KW - Myocardial Infarction/complications
KW - Netherlands/epidemiology
KW - Registries
KW - Retrospective Studies
KW - Shock, Cardiogenic/etiology
KW - Survival Rate/trends
U2 - 10.1177/2048872618805486
DO - 10.1177/2048872618805486
M3 - Article
C2 - 30403366
VL - 8
SP - 338
EP - 349
JO - European heart journal. Acute cardiovascular care
JF - European heart journal. Acute cardiovascular care
SN - 2048-8734
IS - 4
ER -
ID: 10648273