• Resuscitation · Jul 2019

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

    • Cedric Davidsen, Erik J S Packer, Kjetil H Løland, Svein Rotevatn, Else L Nygreen, Erlend Eriksen, Anja Øksnes, Jon Herstad, Rune Haaverstad, Øyvind Bleie, and Vegard Tuseth.
    • Department of Heart Disease, Haukeland University Hospital, Bergen, Norway. Electronic address: cedric.davidsen@ihelse.net.
    • Resuscitation. 2019 Jul 1; 140: 178-184.

    AimsTo 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 ResultsFrom 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.ConclusionsIn 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.Copyright © 2019 Elsevier B.V. All rights reserved.

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