Analysis of outcomes for 15,259 US patients with acute myocardial infarction cardiogenic shock (AMICS) supported with the Impella device.

Publication Date

2018

Journal Title

Am Heart J

Abstract

BACKGROUND: The Impella percutaneous ventricular assist device (PVAD) rapidly deploys mechanical circulatory support (MCS) in patients with acute myocardial infarction complicated by cardiogenic shock (AMICS). We present findings from a quality improvement (IQ) registry for US patients with AMICS who received Impella devices.

METHODS AND RESULTS: From January 2009 to December 2016, 46,949 patients from 1010US hospitals were entered into the IQ registry; of these, 15,259 had AMICS. Limited de-identified patient information, product performance, and survival to explantation were recorded. Of those with AMICS, 51% survived to explantation of PVAD. There was a significant difference between survival at explantation with quintile volume at hospitals (range: 0-100%; 30% survival rate in lowest quintile vs. 76% in top quintile; P7/year vs. 51% at sites with ≤1; P<.001).

CONCLUSIONS: In this early clinical experience with Impella support for AMICS, wide variation in outcomes existed across centers. Survival was higher when Impella was used as first support strategy, when invasive hemodynamic monitoring was used, and at centers with higher Impella implantation volume.

Volume Number

202

Pages

33-38

Document Type

Article

Status

Faculty

Facility

School of Medicine

Primary Department

Cardiology

PMID

29803984

DOI

10.1016/j.ahj.2018.03.024

For the public and Northwell Health campuses

Share

COinS