Impella versus extracorporal life support in cardiogenic shock: a propensity score adjusted analysis

Autor: Stephan Windecker, Lukas Hunziker, Christian Jung, Annemarie E. Engström, Holger Thiele, Stephan B. Felix, David Niederseer, Thomas F. Lüscher, Markus Ferrari, Alexander Lauten, José P.S. Henriques, Malte Kelm, Maryna Masyuk, Mathias Busch, Marcus Franz, Mina Karami, Stephan Binnebößel, Bernhard Wernly, Georg Fuernau, Peter Abel
Přispěvatelé: Cardiology, Graduate School, ACS - Atherosclerosis & ischemic syndromes, ACS - Pulmonary hypertension & thrombosis, University of Zurich, Wernly, Bernhard
Jazyk: angličtina
Rok vydání: 2021
Předmět:
medicine.medical_specialty
lcsh:Diseases of the circulatory (Cardiovascular) system
Shock
Cardiogenic
610 Medicine & health
030204 cardiovascular system & hematology
Impella
2705 Cardiology and Cardiovascular Medicine
Extracorporeal life support
03 medical and health sciences
0302 clinical medicine
Mechanical circulatory support
Original Research Articles
Internal medicine
Clinical endpoint
medicine
Humans
Original Research Article
030212 general & internal medicine
Propensity Score
Cardiogenic shock
Retrospective Studies
business.industry
Mortality rate
Retrospective cohort study
Odds ratio
medicine.disease
Treatment Outcome
lcsh:RC666-701
Heart failure
Propensity score matching
10209 Clinic for Cardiology
Cardiology
Heart-Assist Devices
ECMO
Cardiology and Cardiovascular Medicine
business
Zdroj: ESC Heart Failure, Vol 8, Iss 2, Pp 953-961 (2021)
Wernly, Bernhard; Karami, Mina; Engström, Annemarie E; Windecker, Stephan; Hunziker, Lukas; Lüscher, Thomas F; Henriques, Jose P; Ferrari, Markus W; Binnebößel, Stephan; Masyuk, Maryna; Niederseer, David; Abel, Peter; Fuernau, Georg; Franz, Marcus; Kelm, Malte; Busch, Mathias C; Felix, Stephan B; Thiele, Holger; Lauten, Alexander and Jung, Christian (2021). Impella versus extracorporal life support in cardiogenic shock: a propensity score adjusted analysis. ESC Heart Failure, 8(2), pp. 953-961. Wiley 10.1002/ehf2.13200
ESC heart failure, 8(2), 953-961. The Heart Failure Association of the European Society of Cardiology
ESC Heart Failure
ISSN: 2055-5822
DOI: 10.1002/ehf2.13200
Popis: AIMS The mortality in cardiogenic shock (CS) is high. The role of specific mechanical circulatory support (MCS) systems is unclear. We aimed to compare patients receiving Impella versus ECLS (extracorporal life support) with regard to baseline characteristics, feasibility, and outcomes in CS. METHODS AND RESULTS This is a retrospective cohort study including CS patients over 18��years with a complete follow-up of the primary endpoint and available baseline lactate level, receiving haemodynamic support either by Impella 2.5 or ECLS from two European registries. The decision for device implementation was made at the discretion of the treating physician. The primary endpoint of this study was all-cause mortality at 30��days. A propensity score for the use of Impella was calculated, and multivariable logistic regression was used to obtain adjusted odds ratios (aOR). In total, 149 patients were included, receiving either Impella (n��=��73) or ECLS (n��=��76) for CS. The feasibility of device implantation was high (87%) and similar (aOR: 3.14; 95% CI: 0.18-56.50; P��=��0.41) with both systems. The rates of vascular injuries (aOR: 0.95; 95% CI: 0.10-3.50; P��=��0.56) and bleedings requiring transfusions (aOR: 0.44; 95% CI: 0.09-2.10; P��=��0.29) were similar in ECLS patients and Impella patients. The use of Impella or ECLS was not associated with increased odds of mortality (aOR: 4.19; 95% CI: 0.53-33.25; P��=��0.17), after correction for propensity score and baseline lactate level. Baseline lactate level was independently associated with increased odds of 30��day mortality (per mmol/L increase; OR: 1.29; 95% CI: 1.14-1.45; P��
Databáze: OpenAIRE
Externí odkaz: