Impella use in acute myocardial infarction complicated by cardiogenic shock and cardiac arrest: Analysis of 10 years registry data.

Authors:
Cedric Davidsen
Cedric Davidsen
Haukeland universitetssykehus
Norway
Svein Rotevatn
Svein Rotevatn
Haukeland University Hospital
Norway
Else L Nygreen
Else L Nygreen
Haukeland University Hospital
Norway
Erlend Eriksen
Erlend Eriksen
Haukeland University Hospital
Norway
Jon Herstad
Jon Herstad
Haukeland University Hospital

Resuscitation 2019 Apr 19. Epub 2019 Apr 19.

Department of Heart Disease, Haukeland University Hospital, Bergen, Norway; Faculty of Medicine, University of Bergen, Bergen, Norway.

Aims: To assess characteristics and outcome of patients treated with Impella for acute myocardial infarction (AMI) complicated by severe cardiogenic shock (CS) or cardiac arrest (CA).

Methods And Results: From 2008 through 2017, 92 patients with AMI complicated by CS were treated with Impella. Survival varied according to clinical presentation. Patients in cardiogenic shock without CA had a 75% 30-day survival. Patients with CA and return of spontaneous circulation (ROSC) had a 43% survival and those with CA and ongoing cardio-pulmonary resuscitation (CPR) had a 6% 30-day survival. Age, pre-existing hypertension, coronary disease, ventilatory support and use of adrenergic agents were associated with worse prognosis. Complications were predominantly access site related.

Conclusions: In this registry of patients with AMICS treated with Impella, hypertension and older age were found to be negatively predictive for survival. Patients without CA had the highest 30-day survival. In patients with ROSC, survival was strongly related to age and comorbidity. Patients with ongoing CPR had very high mortality.

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Source
https://linkinghub.elsevier.com/retrieve/pii/S03009572193013
Publisher Site
http://dx.doi.org/10.1016/j.resuscitation.2019.04.022DOI Listing
April 2019
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