Long-term 5-year outcome of the randomized IMPRESS in severe shock trial
| Autor: | Marije M. Vis, Bimmer E. Claessen, Jan Baan, Dagmar M. Ouweneel, Mina Karami, Annemarie E. Engström, Erik J S Packer, Krischan D. Sjauw, Erlend Eriksen, José P.S. Henriques, Wim K. Lagrand, Alexander P.J. Vlaar, Marcel A.M. Beijk |
|---|---|
| Přispěvatelé: | Cardiology, ACS - Pulmonary hypertension & thrombosis, ACS - Atherosclerosis & ischemic syndromes, APH - Aging & Later Life, Intensive Care Medicine, ACS - Microcirculation, Amsterdam Neuroscience - Neuroinfection & -inflammation |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Shock Cardiogenic/etiology medicine.medical_treatment Left Myocardial Infarction Shock Cardiogenic Acute myocardial infarction 030204 cardiovascular system & hematology Critical Care and Intensive Care Medicine Ventricular Function Left Angina 03 medical and health sciences 0302 clinical medicine Mechanical circulatory support Internal medicine Cardiogenic/etiology medicine Humans Ventricular Function AcademicSubjects/MED00200 030212 general & internal medicine Myocardial infarction Stroke Heart Failure and Cardiomyopathies AcademicSubjects/MED00460 Cardiogenic shock Impella Intra-aortic balloon pump Original Scientific Paper Ejection fraction Intra-Aortic Balloon Pumping business.industry Myocardial Infarction/complications Percutaneous coronary intervention Shock Stroke Volume General Medicine medicine.disease AcademicSubjects/MED00170 Treatment Outcome Randomized controlled trial Cardiology Cardiology and Cardiovascular Medicine business |
| Zdroj: | European Heart Journal. Acute Cardiovascular Care European heart journal. Acute cardiovascular care, 10(9), 1009-1015. SAGE Publications Ltd |
| ISSN: | 2048-8734 |
| DOI: | 10.1093/ehjacc/zuab060 |
| Popis: | Aims To assess differences in long-term outcome and functional status of patients with cardiogenic shock (CS) treated by percutaneous mechanical circulatory support (pMCS) and intra-aortic balloon pump (IABP). Methods and results Long-term follow-up of the multicentre, randomized IMPRESS in Severe Shock trial (NTR3450) was performed 5-year after initial randomization. Between 2012 and 2015, a total of 48 patients with severe CS from acute myocardial infarction (AMI) with ST-segment elevation undergoing immediate revascularization were randomized to pMCS by Impella CP (n = 24) or IABP (n = 24). For the 5-year assessment, all-cause mortality, functional status, and occurrence of major adverse cardiac and cerebrovascular event (MACCE) were assessed. MACCE consisted of death, myocardial re-infarction, repeat percutaneous coronary intervention, coronary artery bypass grafting, and stroke. Five-year mortality was 50% (n = 12/24) in pMCS patients and 63% (n = 15/24) in IABP patients (relative risk 0.87, 95% confidence interval 0.47–1.59, P = 0.65). MACCE occurred in 12/24 (50%) of the pMCS patients vs. 19/24 (79%) of the IABP patients (P = 0.07). All survivors except for one were in New York Heart Association Class I/II [pMCS n = 10 (91%) and IABP n = 7 (100%), P = 1.00] and none of the patients had residual angina. There were no differences in left ventricular ejection fraction between the groups (pMCS 52 ± 11% vs. IABP 48 ± 10%, P = 0.53). Conclusions In this explorative randomized trial of patients with severe CS after AMI, there was no difference in long-term 5-year mortality between pMCS and IABP-treated patients, supporting previously published short-term data and in accordance with other long-term CS trials. Graphical Abstract |
| Databáze: | OpenAIRE |
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